Organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Other names
Dental Care at East Sandidge Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
9035 E SANDIDGE RD STE 100, OLIVE BRANCH, MS 38654-3563
(662) 895-7338
Mailing address
9035 E SANDIDGE RD STE 100, OLIVE BRANCH, MS 38654-3563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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