| Pediatric Dental Group | |
|
7734 Airways Blvd Southaven MS 38671-5306 | |
| (662) 349-3838 | |
| (662) 349-5923 |
| Full Name | Pediatric Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7734 Airways Blvd, Southaven, Mississippi |
| Authorized Official Name and Position | Lori Orfans (OFFC MGR) |
| Authorized Official Contact | 6623493838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Group 7734 Airways Blvd Southaven MS 38671-5306 Ph: (662) 349-3838 | Pediatric Dental Group 7734 Airways Blvd Southaven MS 38671-5306 Ph: (662) 349-3838 |
| NPI Number | 1639235963 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 02/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639235963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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