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Individual

MS. SHAMINA KHANUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DENTIST

Contact information

Practice address
3502 WEST NORTHSIDE DRIVE, JACKSON, MS 39213
(601) 362-5321
(601) 364-2600
Mailing address
3502 WEST NORTHSIDE DRIVE, JACKSON HINDS COMPREHENSIVE, TUPELO, MS 38801
(601) 362-5321
(601) 364-2600

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4090-19
MS

Other

Enumeration date
06/06/2014
Last updated
01/15/2025
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