Individual
KALIN MCCABE ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1425 SIMPSON, US 49, MAGEE, MS 39111-3911
(601) 849-4949
Mailing address
100 BASSETT LN, MADISON, MS 39110-6500
(601) 395-6017
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4208-21
MS
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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