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Individual

DR. JOHN D. MITCHELL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
59 FRONTAGE RD N, MACON, MS 39341
(662) 726-4344
(662) 285-6896
Mailing address
PO BOX 306, MACON, MS 39341
(662) 285-6828
(662) 285-6896

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2685-92
MS
122300000X
Dentist
2685920
MS
1223G0001X
General Practice Dentistry
2685-92
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03806868
MS
Enumeration date
01/24/2007
Last updated
06/27/2022
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