| Vicksburg Family Dental 61n | |
|
1650 Highway 61 N Vicksburg MS 39183-3522 | |
| (601) 629-6066 | |
| Not Available |
| Full Name | Vicksburg Family Dental 61n |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1650 Highway 61 N, Vicksburg, Mississippi |
| Authorized Official Name and Position | Terry Lake Garner (OWNER) |
| Authorized Official Contact | 6016296066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicksburg Family Dental 61n 1650 Highway 61 N Vicksburg MS 39183-3522 Ph: () - | Vicksburg Family Dental 61n 1650 Highway 61 N Vicksburg MS 39183-3522 Ph: (601) 629-6066 |
| NPI Number | 1649626573 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 05/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649626573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Mississippi) | Primary |
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