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504 Keywood Cir Ste A Flowood MS 39232-3027 | |
| (601) 351-5651 | |
| (601) 351-9871 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 504 Keywood Cir Ste A, Flowood, Mississippi |
| Authorized Official Name and Position | Wesley Shields (OWNER) |
| Authorized Official Contact | 6013515651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
504 Keywood Cir Ste A Flowood MS 39232-3027 Ph: (601) 351-5651 | 504 Keywood Cir Ste A Flowood MS 39232-3027 Ph: (601) 351-5651 |
| NPI Number | 1972317626 |
|---|---|
| Provider Enumeration Date | 02/04/2025 |
| Last Update Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972317626 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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