Organization
PETAL FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J HARRELL JR. D.M.D. (PARTNER/DENTIST)
(601) 584-9481
Entity
Organization
Contact information
Practice address
139 S MAIN ST, PETAL, MS 39465-2331
(601) 584-9481
(601) 544-5161
Mailing address
139 S MAIN ST, PETAL, MS 39465-2331
(601) 584-9481
(601) 544-5161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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