Individual
DR. JAMES ROBERT HOUSE IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1437 OLD SQUARE RD, JACKSON, MS 39211-5535
(601) 203-0955
Mailing address
1437 OLD SQUARE RD STE 203, JACKSON, MS 39211-5534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4013-18
MS
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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