| Southern Oral And Maxillofacial Surgery Center, Inc | |
|
1205 Mission Park Dr Vicksburg MS 39180-3747 | |
| (601) 661-0034 | |
| (601) 661-0367 |
| Full Name | Southern Oral And Maxillofacial Surgery Center, Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1205 Mission Park Dr, Vicksburg, Mississippi |
| Authorized Official Name and Position | Kevin Keith Keen (SURGEON/OWNER) |
| Authorized Official Contact | 6016610034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oral And Maxillofacial Surgery Center, Inc 1205 Mission Park Dr Vicksburg MS 39180-3747 Ph: (601) 661-0034 | Southern Oral And Maxillofacial Surgery Center, Inc 1205 Mission Park Dr Vicksburg MS 39180-3747 Ph: (601) 661-0034 |
| NPI Number | 1073784880 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 03/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073784880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2951-96 (Mississippi) | Primary |
Janet S Fisher Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Delta Orthodontic Specialists Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 Grove Street, Vicksburg, MS 39183 Phone: 601-638-8230 Fax: 601-636-3388 | |
Jackson Hinds Comprehensive Health Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3312 Oak St, Vicksburg, MS 39180 Phone: 601-629-9500 Fax: 601-638-9044 | |
Margo R Marveggio Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Mission 66, Vicksburg, MS 39183 Phone: 601-636-6081 | |
Vicksburg Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Robert A. Sadler Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1016 Mission 66, Vicksburg, MS 39183 Phone: 601-638-3661 |