| North Mississippi Periodontics & Implant Dentistry Pllc | |
|
103 Park Gate Ext Tupelo MS 38801-3038 | |
| (662) 842-2448 | |
| (662) 842-8374 |
| Full Name | North Mississippi Periodontics & Implant Dentistry Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 103 Park Gate Ext, Tupelo, Mississippi |
| Authorized Official Name and Position | James Michael Robertson (PRESIDENT) |
| Authorized Official Contact | 6628422448 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Mississippi Periodontics & Implant Dentistry Pllc 103 Park Gate Ext Tupelo MS 38801-3038 Ph: (662) 842-2448 | North Mississippi Periodontics & Implant Dentistry Pllc 103 Park Gate Ext Tupelo MS 38801-3038 Ph: (662) 842-2448 |
| NPI Number | 1932531373 |
|---|---|
| Provider Enumeration Date | 08/08/2013 |
| Last Update Date | 08/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932531373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 2571-90 (Mississippi) | Primary |
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