Individual
DR. CHANDRA M. MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1047 W GALLMAN RD, HAZLEHURST, MS 39083-9452
(601) 955-7844
Mailing address
201 RIVERWIND DR, PEARL, MS 39208-5653
(601) 965-9561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3651-12
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR-484-14
MS
Other
Enumeration date
11/26/2013
Last updated
10/08/2018
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