| Terrace Hill Dental Center Llc | |
|
6654 U S Highway 98 Hattiesburg MS 39402-7936 | |
| (601) 264-5756 | |
| (601) 264-5013 |
| Full Name | Terrace Hill Dental Center Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6654 U S Highway 98, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Felder E Wallace (DENTIST/CO-OWNER) |
| Authorized Official Contact | 6012645756 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Terrace Hill Dental Center Llc 6654 U S Highway 98 Hattiesburg MS 39402-7936 Ph: (601) 264-5756 | Terrace Hill Dental Center Llc 6654 U S Highway 98 Hattiesburg MS 39402-7936 Ph: (601) 264-5756 |
| NPI Number | 1679580518 |
|---|---|
| Provider Enumeration Date | 08/02/2006 |
| Last Update Date | 10/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679580518 | NPI | - | NPPES |
| 1771-77 | Other | MS | DENTIST LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1771.77 (Mississippi) | Primary |
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