Organization
PAUL FAMILY DENTISTRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY PAUL DMD (OWNER)
(662) 746-3491
Entity
Organization
Contact information
Practice address
410 N JERRY CLOWER BLVD, YAZOO CITY, MS 39194-8274
(662) 746-3491
(662) 746-3946
Mailing address
410 N JERRY CLOWER BLVD, YAZOO CITY, MS 39194-8274
(662) 746-3491
(662) 746-3946
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3846
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04271891
—
MS
05
—
07223267
—
MS
Enumeration date
02/25/2014
Last updated
05/20/2014
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