| Columbia Family Dental Llc | |
|
430 Broad St Columbia MS 39429-3006 | |
| (601) 543-6510 | |
| Not Available |
| Full Name | Columbia Family Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 430 Broad St, Columbia, Mississippi |
| Authorized Official Name and Position | Tammy Lowry (OFFICE MANAGER) |
| Authorized Official Contact | 6015436510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Family Dental Llc 430 Broad St Columbia MS 39429-3006 Ph: (601) 543-6510 | Columbia Family Dental Llc 430 Broad St Columbia MS 39429-3006 Ph: (601) 543-6510 |
| NPI Number | 1912475922 |
|---|---|
| Provider Enumeration Date | 11/07/2018 |
| Last Update Date | 11/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912475922 | NPI | - | NPPES |
| 08902788 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Cronin Dentistry Of Columbia Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Broad St., Columbia, MS 39429 Phone: 601-736-1761 Fax: 601-736-1766 |