Organization
WAVELAND DENTAL CENTERPLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANA HAL JONES D.M.D. (OWNER DENTIST)
(228) 270-0044
Entity
Organization
Contact information
Practice address
110 AUDERER BLVD, WAVELAND, MS 39576-2432
(228) 270-0044
(228) 270-0047
Mailing address
110 AUDERER BLVD, WAVELAND, MS 39576-2432
(228) 270-0044
(228) 270-0047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09702778
—
MS
01
—
428436169
BLUE CROSS BLUE SHIELD
MS
Enumeration date
06/27/2007
Last updated
03/25/2011
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