Organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Active
Parent organization
HEARTLAND DENTAL
Other names
Main Street Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEARTLAND DENTAL
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
8747 NORTHWEST DR, SOUTHAVEN, MS 38671-2409
(662) 393-0781
Mailing address
8747 NORTHWEST DR, SOUTHAVEN, MS 38671-2409
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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