| Thames Family Dentistry | |
|
228 Main Street Box 388 Nettleton MS 38858 | |
| (662) 963-7338 | |
| (662) 963-7339 |
| Full Name | Thames Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 228 Main Street, Nettleton, Mississippi |
| Authorized Official Name and Position | Walter A Thames (OWNER) |
| Authorized Official Contact | 6629637338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thames Family Dentistry 228 Main Street Box 388 Nettleton MS 38858 Ph: (662) 963-7338 | Thames Family Dentistry 228 Main Street Box 388 Nettleton MS 38858 Ph: (662) 963-7338 |
| NPI Number | 1295972644 |
|---|---|
| Provider Enumeration Date | 01/07/2009 |
| Last Update Date | 01/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295972644 | NPI | - | NPPES |
| 00060277 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2204-85 (Mississippi) | Primary |
Nettleton Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 228 Main St, Nettleton, MS 38858 Phone: 662-963-7338 |