| Mississippi Smiles Dentistry Llc | |
|
310 W Woodrow Wilson Ave 400 Jackson MS 39213 | |
| (769) 230-1940 | |
| (601) 292-6311 |
| Full Name | Mississippi Smiles Dentistry Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 310 W Woodrow Wilson Ave, Jackson, Mississippi |
| Authorized Official Name and Position | Jason Leach (OWNER) |
| Authorized Official Contact | 5202270711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mississippi Smiles Dentistry Llc 310 W Woodrow Wilson Ave 400 Jackson MS 39213 Ph: (769) 230-1940 | Mississippi Smiles Dentistry Llc 310 W Woodrow Wilson Ave 400 Jackson MS 39213 Ph: (769) 230-1940 |
| NPI Number | 1346782893 |
|---|---|
| Provider Enumeration Date | 11/15/2016 |
| Last Update Date | 11/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346782893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 357110 (Mississippi) | Primary |
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