Organization
MISSISSIPPI ENDODONTIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE A STEPHENS (PRACTICE MANAGER)
(601) 420-9322
Entity
Organization
Contact information
Practice address
797 LIBERTY RD, FLOWOOD, MS 39232-9351
(601) 420-9322
(601) 420-9363
Mailing address
797 LIBERTY RD, FLOWOOD, MS 39232-9351
(601) 420-9322
(601) 420-9363
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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