Organization
DESOTO COUNTY FAMILY DENTISTRY, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY MARSHAL WOODS D.M.D. (MANAGER)
(662) 429-3000
Entity
Organization
Contact information
Practice address
2631 MCINGVALE RD, SUITE 104, HERNANDO, MS 38632-5934
(662) 429-3000
(662) 429-3008
Mailing address
2631 MCINGVALE, SUITE 104, HERNANDO, MS 38632-0524
(910) 409-9843
(662) 429-3008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3584-08
MS
Other
Enumeration date
11/11/2008
Last updated
09/07/2011
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