| 1st Dental, Llc | |
|
313 S 40th Ave Hattiesburg MS 39402-1734 | |
| (601) 264-5100 | |
| (601) 264-6669 |
| Full Name | 1st Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 313 S 40th Ave, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Joseph J Daho (OWNER) |
| Authorized Official Contact | 6012645100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1st Dental, Llc 313 S 40th Ave Hattiesburg MS 39402-1734 Ph: (601) 264-5100 | 1st Dental, Llc 313 S 40th Ave Hattiesburg MS 39402-1734 Ph: (601) 264-5100 |
| NPI Number | 1740642834 |
|---|---|
| Provider Enumeration Date | 03/28/2016 |
| Last Update Date | 03/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740642834 | NPI | - | NPPES |
| 06680271 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Mississippi) | Primary |
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