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Individual

DR. BETTYE RUTH BAPTIST-WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1305 CHURCH RD E, SOUTHAVEN, MS 38671-9711
(662) 349-1141
(662) 349-6227
Mailing address
PO BOX 1168, SOUTHAVEN, MS 38671-0012
(662) 349-1141
(662) 349-6227

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1864-80
MS

Other

Enumeration date
07/14/2006
Last updated
07/14/2011
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