Organization
TERRACE HILL DENTAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REAGAN BRYANT (ASST. BUSINESS MANAGER)
(601) 264-5756
Entity
Organization
Contact information
Practice address
271 HWY 589, PURVIS, MS 39475
(601) 264-5756
Mailing address
271 HWY 589, PURVIS, MS 39475-9999
(601) 264-5756
(601) 264-6200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1771-77
MS
1223G0001X
General Practice Dentistry
3353-05
MS
1223G0001X
General Practice Dentistry
3417-07
MS
1223G0001X
General Practice Dentistry
3747-14
MS
Other
Enumeration date
12/07/2016
Last updated
09/18/2017
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