Children's Dental Group Pllc | |
539a Highway 80 W Clinton MS 39056-4193 | |
(601) 924-4900 | |
Not Available |
Full Name | Children's Dental Group Pllc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 539a Highway 80 W, Clinton, Mississippi |
Authorized Official Name and Position | Joseph Chet Gatewood (OWNER) |
Authorized Official Contact | 6019244900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Children's Dental Group Pllc 539a Highway 80 W Clinton MS 39056-4193 Ph: (601) 924-4900 | Children's Dental Group Pllc 539a Highway 80 W Clinton MS 39056-4193 Ph: (601) 924-4900 |
NPI Number | 1477725851 |
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Provider Enumeration Date | 03/26/2008 |
Last Update Date | 06/24/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477725851 | NPI | - | NPPES |
00660116 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 2696 (Mississippi) | Primary |
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