Organization
SMILE DESIGN ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANDRA M. MINOR DMD (OWNER)
(601) 955-7844
Entity
Organization
Contact information
Practice address
1047 W GALLMAN RD, HAZLEHURST, MS 39083-9452
(601) 955-7844
Mailing address
1047 W GALLMAN RD, HAZLEHURST, MS 39083-9452
(601) 955-7844
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3651-12
MS
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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