Organization
ESCATAWPA FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY PARKER DMD (OWNER)
(228) 392-0509
Entity
Organization
Contact information
Practice address
8016 HIGHWAY 613, ESCATAWPA, MS 39552
(228) 474-1314
Mailing address
8016 HIGHWAY 613, MOSS POINT, MS 39562-8200
(228) 474-1314
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MS
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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