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Individual

DR. HEATHER KILLEBREW TUTOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
102 CARROLLTON AVE, LEXINGTON, MS 39095-3250
(662) 834-9899
(662) 834-9895
Mailing address
102 CARROLLTON AVE, P O BOX 734, LEXINGTON, MS 39095-3250
(662) 834-9899
(662) 834-9895

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3145-00
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015878
MS
Enumeration date
08/09/2006
Last updated
07/08/2007
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