| First Dental, Pa | |
|
313 S 40th Ave Hattiesburg MS 39402-1734 | |
| (601) 264-5100 | |
| (601) 264-6669 |
| Full Name | First Dental, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 313 S 40th Ave, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Robin A Wilson (OFFICE MANAGER) |
| Authorized Official Contact | 6012645100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Dental, Pa Po Box 17798 Hattiesburg MS 39404-7798 Ph: (601) 264-5100 | First Dental, Pa 313 S 40th Ave Hattiesburg MS 39402-1734 Ph: (601) 264-5100 |
| NPI Number | 1316035207 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316035207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1453-71 (Mississippi) | Primary |
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