| Mid Town Dental | |
|
808 N State St Suite A Jackson MS 39202-2602 | |
| (601) 355-5275 | |
| Not Available |
| Full Name | Mid Town Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 808 N State St, Jackson, Mississippi |
| Authorized Official Name and Position | Stevey Gaddis (OFFICE MANAGER) |
| Authorized Official Contact | 6013555275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid Town Dental 808 N State St Jackson MS 39202-2602 Ph: (601) 355-5275 | Mid Town Dental 808 N State St Suite A Jackson MS 39202-2602 Ph: (601) 355-5275 |
| NPI Number | 1861816670 |
|---|---|
| Provider Enumeration Date | 02/13/2014 |
| Last Update Date | 02/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861816670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 294096 (Mississippi) | Primary |
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