Organization
ORAL & MAXILLOFACIAL SURGERY CLINIC OF SOUTH MISSSISSIPPI, P.A.
Active
Other names
Drs. York, Bishop & West, Hattiesburg Oral Surgery, Drs. York, Cockerham & Hughes
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA P ODOM (ADMINISTRATOR)
(601) 261-9317
Entity
Organization
Contact information
Practice address
1421 S 28TH AVE, HATTIESBURG, MS 39402-3108
(601) 264-7611
(601) 268-0693
Mailing address
1421 S 28TH AVE, HATTIESBURG, MS 39402-3108
(601) 264-7611
(601) 268-0693
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06271376
—
MS
Enumeration date
07/08/2006
Last updated
07/22/2020
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