Harry Vincent Precheur, D.M.D.

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Jackson, MS

NPI 1104927243 · NPPES record last updated Sep 15, 2010

Key facts

NPI
1104927243
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
OS372-03 (MS)
Practice address
2500 N. State St.
School of Dentistry
Jackson, MS 39216
Phone
(601) 984-6090
Fax
(601) 984-4949
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OS372-03MSMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgery Group, PA Oral and Maxillofacial Surgery Past
since Apr 20, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3282-03 MS
Oral and Maxillofacial Surgery (Dentist) 1223S0112X OS372-03 MS Yes

Addresses

Primary practice location

2500 N. State St.
School of Dentistry
Jackson, MS 39216

Mailing address

2500 N. State St.
School of Dentistry
Jackson, MS 39216
Phone (601) 984-6090

Other identifiers

IdentifierTypeStateIssuer
03637857MedicaidMS

Other providers in Jackson, MS

All providers in Jackson, MS · Oral and Maxillofacial Surgery (Dentist) in Mississippi

Sources for this page

Verify at the official NPI Registry.