Organization
HUMPHREYS DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CHANDLER HUMPHREYS DMD (OWNER)
(601) 794-8115
Entity
Organization
Contact information
Practice address
444 SHELBY SPEIGHTS DRIVE, PURVIS, MS 39475
(601) 794-8115
(601) 794-8115
Mailing address
444 SHELBY SPEIGHTS DRIVE, PURVIS, MS 39475
(601) 794-8115
(601) 794-8115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3329-05
MS
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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