Individual
NATALIE CARRUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9880 GOODMAN ROAD, OLIVE BRANCH, MS 38654
(662) 470-4919
Mailing address
9880 GOODMAN ROAD, OLIVE BRANCH, MS 38654
(662) 470-4919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3712-13
MS
1223G0001X
General Practice Dentistry
9661
TN
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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