Organization
ROSS DENTAL CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE EICHELBERGER ROSS D.M.D. (PRESIDENT)
(601) 732-6200
Entity
Organization
Contact information
Practice address
233 WOODLAND ST, MORTON, MS 39117-3711
(601) 732-6200
(601) 732-6624
Mailing address
233 WOODLAND ST, P.O. BOX 19, MORTON, MS 39117-3711
(601) 732-6200
(601) 732-6624
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2747-93
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660051
—
MS
Enumeration date
05/15/2007
Last updated
08/22/2020
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