| Brett Alan Valentine D.m.d. | |
|
4864-b Hwy 589 Sumrall MS 39482 | |
| (601) 758-0150 | |
| (601) 758-0149 |
| Full Name | Brett Alan Valentine D.m.d. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4864-b Hwy 589, Sumrall, Mississippi |
| Authorized Official Name and Position | Brett A. Valentine (OWNER) |
| Authorized Official Contact | 6017580150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brett Alan Valentine D.m.d. 4864-b Hwy 589 Sumrall MS 39482 Ph: (601) 758-0150 | Brett Alan Valentine D.m.d. 4864-b Hwy 589 Sumrall MS 39482 Ph: (601) 758-0150 |
| NPI Number | 1952572919 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952572919 | NPI | - | NPPES |
| 09015268 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2752-93 (Mississippi) | Primary |
Center Avenue Dental Care, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 90 Center Ave, Sumrall, MS 39482 Phone: 601-758-3535 Fax: 601-758-9225 |