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Individual

PATRICK MILLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
X
Credential
DDS

Contact information

Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6090
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
111354
MS
122300000X
Dentist
12885
TN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/01/2025
Last updated
07/23/2025
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