Individual
DR. VIRGINIA ANGELICO TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1623 S 28TH AVE, HATTIESBURG, MS 39402-3110
(601) 261-5500
Mailing address
1623 S 28TH AVE, HATTIESBURG, MS 39402-3110
(601) 261-5500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2791-93
MS
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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