Organization
CATHERINE JOHNSON MINCY, DDS
Active
Other names
CATHERINE JOHNSON MINCY, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CATHERINE JOHNSON MINCY DDS (OWNER)
(662) 728-8133
Entity
Organization
Contact information
Practice address
607 W CHURCH ST, BOONEVILLE, MS 38829-2647
(662) 728-8133
(662) 728-6903
Mailing address
607 W CHURCH ST, BOONEVILLE, MS 38829-2647
(662) 728-8133
(662) 728-6903
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3009-97
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660215
—
MS
Enumeration date
03/22/2007
Last updated
08/22/2020
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