Organization
FAMILY DENTAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PERRY M WHITES D.M.D. (SHARE HOLDER)
(662) 453-5536
Entity
Organization
Contact information
Practice address
702 HIGHWAY 82 W STE A, GREENWOOD, MS 38930-5069
(662) 453-5536
(662) 453-2324
Mailing address
702 HIGHWAY 82 W STE A, GREENWOOD, MS 38930-5069
(662) 453-5536
(662) 453-2324
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
230286
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060236
—
MS
05
—
00884251
—
MS
05
—
01255511
—
MS
Enumeration date
01/12/2007
Last updated
08/22/2020
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