| Picayune Smiles, Llc | |
|
100 Hayden Oaks Dr Picayune MS 39466-2840 | |
| (601) 798-1135 | |
| Not Available |
| Full Name | Picayune Smiles, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Hayden Oaks Dr, Picayune, Mississippi |
| Authorized Official Name and Position | Joseph J Daho (OWNER) |
| Authorized Official Contact | 6017981135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Picayune Smiles, Llc 100 Hayden Oaks Dr Picayune MS 39466-2840 Ph: (601) 798-1135 | Picayune Smiles, Llc 100 Hayden Oaks Dr Picayune MS 39466-2840 Ph: (601) 798-1135 |
| NPI Number | 1699132423 |
|---|---|
| Provider Enumeration Date | 01/25/2016 |
| Last Update Date | 01/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699132423 | NPI | - | NPPES |
| 06680271 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 345108 (Mississippi) | Primary |
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