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101 Park Gate Dr Tupelo MS 38801-3033 | |
| (662) 840-1535 | |
| (662) 844-3823 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Park Gate Dr, Tupelo, Mississippi |
| Authorized Official Name and Position | John P Kenney (PARTNERSHIP) |
| Authorized Official Contact | 6628401535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
101 Parkgate Dr Tupelo MS 38801 Ph: (662) 840-1535 | 101 Park Gate Dr Tupelo MS 38801-3033 Ph: (662) 840-1535 |
| NPI Number | 1134246630 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134246630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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