| Leaf River Dental, Pllc | |
|
1115 Evelyn Gandy Parkway Petal MS 39465 | |
| (601) 271-8710 | |
| Not Available |
| Full Name | Leaf River Dental, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1115 Evelyn Gandy Parkway, Petal, Mississippi |
| Authorized Official Name and Position | Lanthea Mangum (COO) |
| Authorized Official Contact | 6012718710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leaf River Dental, Pllc 4358 Lincoln Road Ext Ste 20 Hattiesburg MS 39402-3275 Ph: (601) 271-8710 | Leaf River Dental, Pllc 1115 Evelyn Gandy Parkway Petal MS 39465 Ph: (601) 271-8710 |
| NPI Number | 1750906707 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 06/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750906707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Terrace Hill Dental Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1126 Evelyn Gandy Parkway, Petal, MS 39465 Phone: 601-264-5756 Fax: 601-264-6200 | |
Magnolia Smiles Of Petal Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1229 Highway 42 Ste 160-170, Petal, MS 39465 Phone: 601-735-5086 | |
Petal Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 139 S Main St, Petal, MS 39465 Phone: 601-584-9481 Fax: 601-544-5161 |