Organization
CARY CHRISTIAN DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLLIE HARDAWAY JR. (DENTIST)
(601) 529-5196
Entity
Organization
Contact information
Practice address
154 COTTONWOOD ST., CARY, MS 39054
(662) 873-4593
Mailing address
PO BOX 57, CARY, MS 39054-0057
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
1801-78
MS
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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