| Children's Dental Center | |
|
1420 Wooded Drive Grenada MS 38901 | |
| (662) 513-4188 | |
| (662) 513-4180 |
| Full Name | Children's Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1420 Wooded Drive, Grenada, Mississippi |
| Authorized Official Name and Position | Charles H Perkins (PRINCIPAL) |
| Authorized Official Contact | 6625134188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Center 1420 Wooded Drive Grenada MS 38901 Ph: () - | Children's Dental Center 1420 Wooded Drive Grenada MS 38901 Ph: (662) 513-4188 |
| NPI Number | 1114359866 |
|---|---|
| Provider Enumeration Date | 08/05/2013 |
| Last Update Date | 08/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114359866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 3306-04 (Mississippi) | Primary |
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