Individual
RODERICK L COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
120 HOLT COLLIER DR, SUITE D, VICKSBURG, MS 39183-4408
(601) 619-4777
(601) 619-4667
Mailing address
120 HOLT COLLIER DR, SUITE D, VICKSBURG, MS 39183-4408
(601) 619-4777
(601) 619-4667
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3153-00
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660349
—
MS
05
—
02988820
—
MS
Enumeration date
03/07/2007
Last updated
07/09/2007
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