Organization
TODD DIXON FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN TODD DIXON DMD (DENTIST)
(601) 583-6613
Entity
Organization
Contact information
Practice address
26 PARKWAY BLVD, HATTIESBURG, MS 39401-8879
(601) 583-6613
(601) 583-9832
Mailing address
26 PARKWAY BLVD, HATTIESBURG, MS 39401-8879
(601) 583-6613
(601) 583-9832
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660391
—
MS
Enumeration date
08/26/2019
Last updated
09/24/2019
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