Organization
CHILDREN'S DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGH C SMITH JR. DDS (PEDIATRIC DENTIST)
(662) 843-5011
Entity
Organization
Contact information
Practice address
303 HOSPITAL DR, CLEVELAND, MS 38732-2358
(662) 843-5011
Mailing address
303 HOSPITAL DR, CLEVELAND, MS 38732-2358
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
169975
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064290
—
MS
Enumeration date
05/16/2011
Last updated
05/16/2011
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