Organization
ORAL AND FACIAL SURGERY OF MISSISSIPPI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R NICHOLS DMD, MD (PRESIDENT)
(601) 420-3223
Entity
Organization
Contact information
Practice address
266 KATHERINE DR, FLOWOOD, MS 39232-8801
(601) 420-3223
(601) 420-3054
Mailing address
266 KATHERINE DR, FLOWOOD, MS 39232-8801
(601) 420-3223
(601) 420-3054
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
OS34000
MS
Other
Enumeration date
10/16/2008
Last updated
10/16/2008
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