Organization
OXFORD DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY J. PACE (INSURANCE COORDINATOR)
(662) 234-5222
Entity
Organization
Contact information
Practice address
2155 S LAMAR BLVD, OXFORD, MS 38655-5223
(662) 234-5222
(662) 234-5254
Mailing address
2155 SOUTH LAMAR BLVD, OXFORD, MS 38655-2018
(662) 234-5222
(662) 234-5254
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1700-75
TN
1223G0001X
General Practice Dentistry
Primary
2825-94
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0064235
—
MS
05
—
0660083
—
MS
Enumeration date
10/12/2006
Last updated
10/30/2008
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