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Organization

WESTSIDE DENTAL, PLLC

Active
Other names
Austin Dental Clinic PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENNETH LEE AUSTIN DMD (MANAGER)
(662) 842-8035
Entity
Organization

Contact information

Practice address
3694 W JACKSON ST, TUPELO, MS 38801
(662) 842-8035
(662) 842-3018
Mailing address
3694 W JACKSON ST, TUPELO, MS 38801
(662) 842-8035
(662) 842-3018

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
298897
MS
122300000X
Dentist
Primary
303298
MS

Other

Enumeration date
03/19/2007
Last updated
06/23/2023
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