Individual
DR. JEANNA LYN AULTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4556 HIGHWAY 589, SUMRALL, MS 39482-3979
(601) 758-0150
(601) 758-0149
Mailing address
PO BOX 469, SUMRALL, MS 39482
(601) 758-0150
(601) 758-0149
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3690-13
MS
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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