Organization
PICAYUNE SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH J DAHO DDS (OWNER)
(601) 798-1135
Entity
Organization
Contact information
Practice address
100 HAYDEN OAKS DR, PICAYUNE, MS 39466-2840
(601) 798-1135
Mailing address
100 HAYDEN OAKS DR, PICAYUNE, MS 39466-2840
(601) 798-1135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
345108
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06680271
—
MS
Enumeration date
01/25/2016
Last updated
01/25/2016
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