Organization
SUNFLOWER DENTAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY D TANKERSLEY DMD (DENTIST/OWNER)
(662) 756-0000
Entity
Organization
Contact information
Practice address
102 N RUBY AVE, RULEVILLE, MS 38771-3940
(662) 756-0000
(662) 756-0017
Mailing address
PO BOX 98, RULEVILLE, MS 38771-0098
(662) 756-0000
(662) 756-0017
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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