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Organization

OLIVE BRANCH DENTAL CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE RENEE CALLOWAY (OFFICE MANAGER)
(662) 895-5012
Entity
Organization

Contact information

Practice address
8935 GOODMAN RD, OLIVE BRANCH, MS 38654-2201
(662) 895-5012
Mailing address
8935 GOODMAN RD, OLIVE BRANCH, MS 38654-2201
(662) 895-5012

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
05/20/2010
Last updated
05/20/2010
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