| Liberty Dental Services | |
|
102 West Freedom Drive Liberty MS 39645 | |
| (601) 657-1236 | |
| (601) 657-9181 |
| Full Name | Liberty Dental Services |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 102 West Freedom Drive, Liberty, Mississippi |
| Authorized Official Name and Position | Pam T. Poole (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6016574326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Dental Services Po Box 511 Liberty MS 39645-0511 Ph: (601) 657-1236 | Liberty Dental Services 102 West Freedom Drive Liberty MS 39645 Ph: (601) 657-1236 |
| NPI Number | 1659693083 |
|---|---|
| Provider Enumeration Date | 02/26/2010 |
| Last Update Date | 02/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659693083 | NPI | - | NPPES |
| 09015383 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Amite County Medical Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 102 West Freedom Drive, Liberty, MS 39645 Phone: 601-657-4326 Fax: 601-657-8867 | |
Fmch Liberty Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1410 Main St. East, Liberty, MS 39645 Phone: 601-657-8820 |