Individual
DR. TERESA MIXON PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5550 RIDGEWOOD RD STE A, JACKSON, MS 39211-4024
(601) 981-9303
(601) 981-9304
Mailing address
5550 RIDGEWOOD RD, JACKSON, MS 39211-4024
(601) 398-6434
(601) 981-9304
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
242188
MS
1223P0221X
Pediatric Dentistry
4749
LA
1223P0221X
Pediatric Dentistry
PEDO16589
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02058365
—
MS
05
—
1847496
—
LA
Enumeration date
01/05/2007
Last updated
09/19/2020
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