| Hernando Dental Group Incorporated | |
|
2264 Mcingvale Rd. Hernando MS 38632 | |
| (662) 429-6736 | |
| (662) 429-6752 |
| Full Name | Hernando Dental Group Incorporated |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2264 Mcingvale Rd., Hernando, Mississippi |
| Authorized Official Name and Position | Amy R Wadsworth (PARTNER) |
| Authorized Official Contact | 6624296736 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hernando Dental Group Incorporated 2264 Mcingvale Rd Hernando MS 38632 Ph: (662) 429-6736 | Hernando Dental Group Incorporated 2264 Mcingvale Rd. Hernando MS 38632 Ph: (662) 429-6736 |
| NPI Number | 1871831552 |
|---|---|
| Provider Enumeration Date | 01/30/2013 |
| Last Update Date | 01/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871831552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3018-97 (Mississippi) | Primary |
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