Organization
PEARL RIVER DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY TOUPS (CEO)
(601) 271-8710
Entity
Organization
Contact information
Practice address
209 RIVERWIND EAST DR, PEARL, MS 39208
(601) 936-6161
(601) 936-6163
Mailing address
209 RIVERWIND EAST DR, PEARL, MS 39208
(601) 936-6161
(603) 936-6163
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2940-96
MS
Other
Enumeration date
08/12/2014
Last updated
07/21/2022
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