Organization
1ST DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH J DAHO DDS (OWNER)
(601) 264-5100
Entity
Organization
Contact information
Practice address
313 S 40TH AVE, HATTIESBURG, MS 39402-1734
(601) 264-5100
(601) 264-6669
Mailing address
313 S 40TH AVE, HATTIESBURG, MS 39402-1734
(601) 264-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06680271
—
MS
Enumeration date
03/28/2016
Last updated
03/28/2016
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