Organization
BENDER DENTAL ASSOCIATES
Active
Parent organization
BENDER DENTAL ASSOCIATES
Organization subpart
Yes
Provider details
NPI number
Legal business name
BENDER DENTAL ASSOCIATES
Authorized official
DR. TERESA MANOGIN BENDER DMD (OWNER)
(601) 362-0460
Entity
Organization
Contact information
Practice address
4550 MANHATTAN RD, JACKSON, MS 39206-6022
(601) 362-0460
Mailing address
4550 MANHATTAN RD, JACKSON, MS 39206-6022
(601) 362-0460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2833-94
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01528564
—
MS
Enumeration date
12/15/2007
Last updated
08/31/2021
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