Organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Other names
MY Vicksburg Dentist
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF MISSISSIPPI, P.C.
Authorized official
KIM WILSON (CRED. SUPERVISOR)
(217) 540-5170
Entity
Organization
Contact information
Practice address
1805 MISSION 66, VICKSBURG, MS 39180-3709
(601) 638-2361
(601) 634-0864
Mailing address
1805 MISSION 66, VICKSBURG, MS 39180-3709
(601) 638-2361
(601) 634-0864
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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