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Organization
MS PERIODONTIC SPECIALISTS GROUP, PLLC
Active
Organization
MS PERIODONTIC SPECIALISTS GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL REID LESTER DMD (OWNER)
(601) 664-2600
Entity
Organization
Contact information
Practice address
209 WOODLINE DR., FLOWOOD, MS 39232
(601) 664-2600
(601) 664-2650
Mailing address
209 WOODLINE DR., FLOWOOD, MS 39232
(601) 664-2600
(601) 664-2650
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
45012
MS
Other
Enumeration date
08/29/2012
Last updated
08/12/2014
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