Organization
FAMILY DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL H SLOVER DMD (OWNER)
(601) 849-6871
Entity
Organization
Contact information
Practice address
203 MAIN AVE N, MAGEE, MS 39111
(601) 849-6871
(601) 849-5257
Mailing address
203 MAIN AVE N, MAGEE, MS 39111-3535
(601) 849-6871
(601) 849-5257
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2692-92
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660036
—
MS
Enumeration date
02/11/2010
Last updated
02/11/2010
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