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Organization

SPARKLING SMILES PEDIATRIC DENTISTRY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MYEASHA BURGESS DDS (OWNER)
(443) 413-2935
Entity
Organization

Contact information

Practice address
949 BROADWAY DR, HATTIESBURG, MS 39401-7534
(601) 620-0075
Mailing address
4 CLEARWATER PT, PETAL, MS 39465-8649
(443) 413-2935

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
03/09/2021
Last updated
03/09/2021
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