Crystal Springs Dental Center, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3439-07 Issued in MS

Legal business name

CRYSTAL SPRINGS DENTAL CENTER, LLC

Practice address

304 Harmony Rd
Crystal Springs, MS 39059-2809

Phone

(901) 282-5706

NPI assigned

Dec 1, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Terrance L Ware, DDS

Title

Owner/Operator

Phone

(901) 282-5706

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1023386372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HARMONY RD",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HARMONY RD",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592809",
            "telephone_number": "901-282-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL SPRINGS DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "901-282-5706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MS",
            "license": "3439-07",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Crystal Springs, MS
• Providers in Crystal Springs, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.