Organization
ASSOCIATED DENTAL OF RIDGELAND, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA MARIE TRUSTY (OFFICE MANAGER)
(601) 919-8575
Entity
Organization
Contact information
Practice address
733 LAKE HARBOUR DR STE G, RIDGELAND, MS 39157-4304
(601) 856-4888
(601) 856-8077
Mailing address
733 LAKE HARBOUR DR STE G, RIDGELAND, MS 39157-4304
(601) 856-4888
(601) 856-8077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3214
MS
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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