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Organization

ADVANCE DENTAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DENESSA V. TOOMBS D.M.D. (OWNER/MANAGER)
(601) 206-1112
Entity
Organization

Contact information

Practice address
1555 E COUNTY LINE RD, JACKSON, MS 39211-1801
(601) 206-1112
(601) 206-1114
Mailing address
1555 E COUNTY LINE RD, JACKSON, MS 39211-1801
(601) 206-1112
(601) 206-1114

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3314-04
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02674220
MS
Enumeration date
09/13/2007
Last updated
09/13/2007
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