Organization
NORTH MS COMMUNITY DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM T. NEELY III DMD (DENTIST/OWNER)
(662) 561-1045
Entity
Organization
Contact information
Practice address
560 HIGHWAY 6 E, EAST OAKS SHOPPING CENTER, BATESVILLE, MS 38606-3002
(662) 561-1045
(662) 561-1181
Mailing address
PO BOX 13409, JACKSON, MS 39236-3409
(662) 561-1045
(662) 561-1181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2650-91
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660095
—
MS
05
—
04581039
—
MS
Enumeration date
07/22/2009
Last updated
07/22/2009
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