Organization
JCC, LLC
Active
Other names
Children's Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON COLEMAN DMD (OWNER)
(662) 298-2095
Entity
Organization
Contact information
Practice address
1150 MONTEITH AVENUE, SUITE 102, HERNANDO, MS 38632
(662) 298-2095
Mailing address
1150 MONTEITH AVENUE, SUITE 102, HERNANDO, MS 38632
(662) 298-2095
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
PEDO 359 02
MS
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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