Organization
MANTACHIE RURAL HEALTH CARE, INC. DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN BURNS (COO)
(662) 282-4226
Entity
Organization
Contact information
Practice address
5500 HWY 363, MANTACHIE, MS 38855-7197
(662) 282-4226
(662) 282-7946
Mailing address
5681 HWY 363, MANTACHIE, MS 38855-7197
(662) 282-4226
(662) 282-7946
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/13/2012
Last updated
10/02/2023
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