| Community Dental, Inc | |
|
908 Municipal Dr Brandon MS 39042-2973 | |
| (601) 825-2150 | |
| (601) 825-2792 |
| Full Name | Community Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 908 Municipal Dr, Brandon, Mississippi |
| Authorized Official Name and Position | Jamaal Edwin Longino (DENTIST/PRESIDENT) |
| Authorized Official Contact | 6018252150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Dental, Inc 908 Municipal Dr Brandon MS 39042-2973 Ph: (601) 825-2150 | Community Dental, Inc 908 Municipal Dr Brandon MS 39042-2973 Ph: (601) 825-2150 |
| NPI Number | 1245539808 |
|---|---|
| Provider Enumeration Date | 03/22/2011 |
| Last Update Date | 03/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245539808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3483-08 (Mississippi) | Primary |
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