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Individual

DR. CATHERINE JOHNSON MINCY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
607 W CHURCH ST, BOONEVILLE, MS 38829-2647
(662) 728-5199
(662) 728-6903
Mailing address
114 WOODRIDGE DR, BOONEVILLE, MS 38829-8294
(662) 728-8133
(662) 728-6903

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3009-97
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015740
MS
Enumeration date
01/22/2007
Last updated
07/09/2007
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