| Sparkling Smiles Pediatric Dentistry, Pllc | |
|
949 Broadway Dr Hattiesburg MS 39401-7534 | |
| (601) 620-0075 | |
| Not Available |
| Full Name | Sparkling Smiles Pediatric Dentistry, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 949 Broadway Dr, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Myeasha Burgess (OWNER) |
| Authorized Official Contact | 4434132935 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparkling Smiles Pediatric Dentistry, Pllc 4 Clearwater Pt Petal MS 39465-8649 Ph: (443) 413-2935 | Sparkling Smiles Pediatric Dentistry, Pllc 949 Broadway Dr Hattiesburg MS 39401-7534 Ph: (601) 620-0075 |
| NPI Number | 1881279016 |
|---|---|
| Provider Enumeration Date | 03/09/2021 |
| Last Update Date | 03/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881279016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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