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Organization
FRIENDS OF MISSISSIPPI DENTISTRY
Active
Organization
FRIENDS OF MISSISSIPPI DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SREENIVAS KOKA DDS (BOARD MEMBER)
(619) 456-3712
Entity
Organization
Contact information
Practice address
105 N BROOKS AVE, PELAHATCHIE, MS 39145-3091
(601) 854-5001
Mailing address
108 CLAIBORNE CHASE, RIDGELAND, MS 39157-9706
(619) 456-3712
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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