Individual
MAI LATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 BROAD ST, COLUMBIA, MS 39429-3006
(601) 736-7125
Mailing address
430 BROAD ST, COLUMBIA, MS 39429-3006
(601) 736-7125
(601) 736-9190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4340-22
MS
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
About Stedi
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