| Austin Family Dentistry | |
|
3040 Indiana Ave Vicksburg MS 39180 | |
| (601) 634-6277 | |
| Not Available |
| Full Name | Austin Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3040 Indiana Ave, Vicksburg, Mississippi |
| Authorized Official Name and Position | Misty L Austin (PRESIDENT) |
| Authorized Official Contact | 6016346277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Family Dentistry 3040 Indiana Ave. Vicksburg MS 39180 Ph: (601) 634-6277 | Austin Family Dentistry 3040 Indiana Ave Vicksburg MS 39180 Ph: (601) 634-6277 |
| NPI Number | 1922217314 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 10/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922217314 | NPI | - | NPPES |
| 09014287 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2063-84 (Mississippi) | Primary |
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