Organization
MS PERIODONTIC SPECIALISTS GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL REID LESTER DMD (OWNER)
(601) 664-2600
Entity
Organization
Contact information
Practice address
209 WOODLINE DR., FLOWOOD, MS 39232
(601) 664-2600
(601) 664-2650
Mailing address
209 WOODLINE DR., FLOWOOD, MS 39232
(601) 664-2600
(601) 664-2650
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
45012
MS
Other
Enumeration date
08/29/2012
Last updated
08/12/2014
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