| Magnolia Smiles Of Petal Pllc | |
|
1229 Highway 42 Ste 160-170 Petal MS 39465-2733 | |
| (601) 735-5086 | |
| Not Available |
| Full Name | Magnolia Smiles Of Petal Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1229 Highway 42 Ste 160-170, Petal, Mississippi |
| Authorized Official Name and Position | Oscar R Jones (OWNER/ DENTIST) |
| Authorized Official Contact | 6017355086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Smiles Of Petal Pllc 1229 Highway 42 Ste 160-170 Petal MS 39465-2733 Ph: (601) 735-5086 | Magnolia Smiles Of Petal Pllc 1229 Highway 42 Ste 160-170 Petal MS 39465-2733 Ph: (601) 735-5086 |
| NPI Number | 1396483871 |
|---|---|
| Provider Enumeration Date | 05/24/2022 |
| Last Update Date | 02/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396483871 | NPI | - | NPPES |
| 200000763 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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