Organization
CAPITAL DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M LEWIS GRUBBS DMD (OWNER/DENTIST)
(601) 362-2660
Entity
Organization
Contact information
Practice address
1771 LELIA DR, JACKSON, MS 39216-4820
(601) 362-2660
(601) 362-6363
Mailing address
1771 LELIA DR, JACKSON, MS 39216-4820
(601) 362-2660
(601) 362-6363
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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