Organization
YAZOO CITY DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM NEWMAN NELSON JR. DDS (OWNER)
(662) 746-1432
Entity
Organization
Contact information
Practice address
1615 EASY STREET, YAZOO, MS 39194-2427
(662) 746-1432
(662) 746-5974
Mailing address
1615 EASY STREET, YAZOO, MS 39194-2427
(662) 746-1432
(662) 746-5974
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015614
—
MS
Enumeration date
03/05/2007
Last updated
08/22/2020
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