Organization
MISSISSIPPI OROFACIAL PAIN, LLC
Active
Other names
Mississippi Orofacial Pain Specialists, Mississippi Orofacial Pain
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL COLEMAN RILEY D.D.S. (AUTHORIZED OFFICIAL)
(769) 567-2555
Entity
Organization
Contact information
Practice address
108 S MAPLE ST STE C, RIDGELAND, MS 39157-2305
(601) 720-7662
Mailing address
108 S MAPLE ST STE C, RIDGELAND, MS 39157-2357
(697) 567-2555
(769) 567-2556
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285640383
PROVIDER NPI
MS
01
—
1639813454
LOCATION NPI
MS
Enumeration date
04/27/2022
Last updated
12/28/2023
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