Individual
DR. LAUREN TYNER CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4463 N STATE ST, JACKSON, MS 39206-5306
(601) 714-2908
Mailing address
4463 N STATE ST, JACKSON, MS 39206-5306
(601) 714-2908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3585-11
MS
1223P0221X
Pediatric Dentistry
3585-11
MS
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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