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
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS372-03 | MS | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oral Surgery Group, PA | Oral and Maxillofacial Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03637857 | Medicaid | MS |
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All providers in Jackson, MS · Oral and Maxillofacial Surgery (Dentist) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.