| Miss-lou Dental Llc | |
|
110 Highway 61 South Natchez MS 39120 | |
| (318) 757-4561 | |
| (318) 757-4595 |
| Full Name | Miss-lou Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 110 Highway 61 South, Natchez, Mississippi |
| Authorized Official Name and Position | James Victor Iverstine (OWNER) |
| Authorized Official Contact | 3187574561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miss-lou Dental Llc 207 Serio Blvd Ferriday LA 71334-2014 Ph: (318) 757-4561 | Miss-lou Dental Llc 110 Highway 61 South Natchez MS 39120 Ph: (318) 757-4561 |
| NPI Number | 1760818017 |
|---|---|
| Provider Enumeration Date | 09/18/2013 |
| Last Update Date | 09/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760818017 | NPI | - | NPPES |
| 1834190 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3678-12 (Mississippi) | Primary |
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