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Individual

DR. MARY CATHERINE BLOSSOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
233 WOODLAND ST, MORTON, MS 39117-3711
(601) 732-6200
(601) 632-6624
Mailing address
233 WOODLAND ST, MORTON, MS 39117-3711
(601) 732-6200
(601) 732-6624

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
369913
MS

Other

Enumeration date
06/11/2013
Last updated
11/13/2014
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