Organization
GRANTS FERRY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLA RUSHING (OWNER)
(601) 992-1605
Entity
Organization
Contact information
Practice address
1075 LAKE VILLAGE CIR, BRANDON, MS 39047-6743
(601) 992-1605
(601) 992-9534
Mailing address
1075 LAKE VILLAGE CIR, BRANDON, MS 39047-6743
(601) 992-1605
(601) 992-9534
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3276-03
MS
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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