| Tupelo Dental Group | |
|
105 Park Gate Dr Tupelo MS 38801-3010 | |
| (662) 844-7231 | |
| (662) 844-0142 |
| Full Name | Tupelo Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 105 Park Gate Dr, Tupelo, Mississippi |
| Authorized Official Name and Position | Peter Lowry West (OWNER) |
| Authorized Official Contact | 6628447231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tupelo Dental Group 105 Park Gate Dr Tupelo MS 38801-3010 Ph: (662) 844-7231 | Tupelo Dental Group 105 Park Gate Dr Tupelo MS 38801-3010 Ph: (662) 844-7231 |
| NPI Number | 1548482862 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548482862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 251489 (Mississippi) | Primary |
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