Individual
SUMRALL POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
990 EBENEZER BLVD., MADISON, MS 39110
(601) 856-3926
(601) 856-8112
Mailing address
17 TWELVE OAKS DR., MADISON, MS 39110
(601) 856-3509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1847-79
MS
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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