Organization
FRESH SMILES PLLC
Active
Other names
Magnolia Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK FITZHUGH BRELAND D.M.D (MANAGER)
(601) 540-8057
Entity
Organization
Contact information
Practice address
513 W COMMERCE ST, ABERDEEN, MS 39730-2543
(601) 540-8057
Mailing address
513 W COMMERCE ST, ABERDEEN, MS 39730-2543
(662) 369-2063
(662) 369-2076
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3592-11
MS
Other
Enumeration date
08/19/2015
Last updated
08/25/2015
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