Organization
MINT DENTAL LLC
Active
Other names
Mint Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTOINETTE LILES DMD (OWNER/OPERATING DENTIST)
(601) 882-5600
Entity
Organization
Contact information
Practice address
190 RIVERWIND DR STE 201, PEARL, MS 39208-3387
(601) 882-5600
(601) 882-5601
Mailing address
190 RIVERWIND DR STE 201, PEARL, MS 39208-3387
(601) 882-5600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
05/17/2021
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