Organization
NORTH SUNFLOWER MEDICAL CENTER DENTISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE DANIEL CEJA (CEO)
(662) 756-2711
Entity
Organization
Contact information
Practice address
840 N OAK AVE, RULEVILLE, MS 38771-3227
(662) 756-2711
(662) 756-0306
Mailing address
PO BOX 369, RULEVILLE, MS 38771-0369
(662) 756-1601
(662) 756-0306
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013627
—
MS
Enumeration date
05/25/2007
Last updated
06/08/2020
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