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Organization

JASON R. ESTEP, DMD, PLLC

Active
Other names
Poplarville Dental Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON R ESTEP DMD (OWNER/DENTIST)
(601) 795-8024
Entity
Organization

Contact information

Practice address
1718 S MAIN ST, POPLARVILLE, MS 39470-4287
(601) 795-8024
(601) 795-0745
Mailing address
PO BOX 73, POPLARVILLE, MS 39470-0073
(601) 795-8024
(601) 795-0745

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3549-10
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06858257
MS
Enumeration date
06/04/2012
Last updated
06/04/2012
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