Organization
ADVANCED DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T. LAKE GARNER DMD (OWNER)
(601) 271-8710
Entity
Organization
Contact information
Practice address
1555 E COUNTY LINE ROAD, JACKSON, MS 39211
(601) 271-8710
Mailing address
4358 LINCOLN RD EXT, SUITE 20, HATTIESBURG, MS 39402
(601) 271-8710
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/31/2017
Last updated
01/31/2017
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