Individual
PROF. CLYDE ARMSTRONG MUSGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3964 GOODMAN RD E STE 128, SOUTHAVEN, MS 38672-6494
(662) 893-7337
(662) 893-7881
Mailing address
2925 NAIL RD E, SUITE 103, SOUTHAVEN, MS 38672-6620
(662) 893-7337
(662) 893-7881
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3136-00
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660434
—
MS
Enumeration date
09/25/2006
Last updated
08/08/2013
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