South Delta Dental Clinic, Llc | |
21 S Fourth St Rolling Fork MS 39159-5146 | |
(662) 873-5170 | |
Not Available |
Full Name | South Delta Dental Clinic, Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 21 S Fourth St, Rolling Fork, Mississippi |
Authorized Official Name and Position | Michael Murphy (CHIEF OPERATING OFFICER) |
Authorized Official Contact | 6019557970 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
South Delta Dental Clinic, Llc 21 S Fourth St Rolling Fork MS 39159-5146 Ph: (662) 873-5170 | South Delta Dental Clinic, Llc 21 S Fourth St Rolling Fork MS 39159-5146 Ph: (662) 873-5170 |
NPI Number | 1902162811 |
---|---|
Provider Enumeration Date | 04/04/2012 |
Last Update Date | 04/04/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902162811 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 360411 (Mississippi) | Primary |