Individual
DR. MILES BACKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2690 HIGHWAY 145, SALTILLO, MS 38866-6941
(662) 869-2100
Mailing address
726 HIGHLAND PARK DR, TUPELO, MS 38801-8901
(662) 397-3749
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3990-18
MS
Other
Enumeration date
08/06/2018
Last updated
02/21/2024
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