# JCC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Children's Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669850004
- **Authorized official:** DR. JASON COLEMAN DMD (OWNER)
- **Authorized official phone:** (662) 298-2095

## Contact information

- **Practice address:** 1150 MONTEITH AVENUE, SUITE 102, HERNANDO, MS 38632
- **Practice address phone:** (662) 298-2095
- **Mailing address:** 1150 MONTEITH AVENUE, SUITE 102, HERNANDO, MS 38632
- **Mailing address phone:** (662) 298-2095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | PEDO 359 02 | MS | Yes |

## Other

- **Enumeration date:** 05/18/2015
- **Last updated:** 05/18/2015