Individual
NORMAN C UNDERWOOD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
6745 S SIWELL RD STE 210, BYRAM, MS 39272-8746
(601) 371-8634
(601) 371-8724
Mailing address
6745 S SIWELL RD STE 210, BYRAM, MS 39272-8746
(601) 371-8634
(601) 371-8724
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2036-83
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060285
—
MS
Enumeration date
07/18/2006
Last updated
05/12/2009
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