Organization
FLORENCE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R BYRD DMD (DOCTOR)
(604) 845-2386
Entity
Organization
Contact information
Practice address
129 EARL CLARK DRIVE, FLORENCE, MS 39073
(601) 845-2386
(601) 845-1470
Mailing address
PO BOX 97632, JACKSON, MS 39288-7632
(601) 845-2386
(601) 845-1470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2401
MS
1223G0001X
General Practice Dentistry
3182
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015190
—
MS
Enumeration date
03/19/2008
Last updated
03/19/2008
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