| Grants Ferry Family Dentistry | |
|
1075 Lake Village Cir Brandon MS 39047-6743 | |
| (601) 992-1605 | |
| (601) 992-9534 |
| Full Name | Grants Ferry Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1075 Lake Village Cir, Brandon, Mississippi |
| Authorized Official Name and Position | Carla Rushing (OWNER) |
| Authorized Official Contact | 6019921605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grants Ferry Family Dentistry 1075 Lake Village Cir Brandon MS 39047-6743 Ph: (601) 992-1605 | Grants Ferry Family Dentistry 1075 Lake Village Cir Brandon MS 39047-6743 Ph: (601) 992-1605 |
| NPI Number | 1265779052 |
|---|---|
| Provider Enumeration Date | 01/14/2013 |
| Last Update Date | 01/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265779052 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3276-03 (Mississippi) | Primary |
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