Organization
COMPUDOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEMONT T NORRIS (PRESIDENT)
(601) 638-7007
Entity
Organization
Contact information
Practice address
1713 CLAY ST, SUITE 5, VICKSBURG, MS 39183-3048
(601) 638-7007
(601) 638-0760
Mailing address
1713 CLAY ST, SUITE 5, VICKSBURG, MS 39183-3048
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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