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Individual

DR. REUBEN ROY LITTLE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
519 BONITA LAKES DRIVE, SUITE B, MERIDIAN, MS 39301-6970
(601) 485-2095
(601) 486-2631
Mailing address
3900 23RD AVE, MERIDIAN, MS 39305-3843
(601) 693-5961
(601) 486-2631

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3204-01
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00660407
MS
Enumeration date
11/08/2006
Last updated
07/09/2007
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