| Lifetime Dental Llc | |
|
910 Medallion Dr Greenwood MS 38930-2118 | |
| (662) 843-8353 | |
| (662) 843-8363 |
| Full Name | Lifetime Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 910 Medallion Dr, Greenwood, Mississippi |
| Authorized Official Name and Position | Daryl Lance Johnson (SOLE PROPRIETOR) |
| Authorized Official Contact | 6628438353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Dental Llc 1313 W Highway 8 Cleveland MS 38732-2240 Ph: (662) 843-8353 | Lifetime Dental Llc 910 Medallion Dr Greenwood MS 38930-2118 Ph: (662) 843-8353 |
| NPI Number | 1679024442 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 10/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679024442 | NPI | - | NPPES |
| 09015931 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2826-94 (Mississippi) | Primary |
Family Dental Associates Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 Highway 82 W Ste A, Greenwood, MS 38930 Phone: 662-453-5536 Fax: 662-453-2324 | |
Gene Baines, D.m.d. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Highway 82 W, Greenwood, MS 38930 Phone: 662-455-3192 Fax: 662-455-3170 | |
Moses Oral And Facial Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 W Park Ave, Greenwood, MS 38930 Phone: 662-219-0044 | |
Dr. Todd Fincher P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 E Market St, Greenwood, MS 38930 Phone: 662-453-1708 | |
Adam Weems D.m.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1705 Strong Ave, Suite A, Greenwood, MS 38930 Phone: 662-453-6243 |