South Delta Dental Clinic, LLC
Organization Active NPI General Practice Dentistry · Rolling Fork, MS
NPI 1902162811 · NPPES record last updated Apr 4, 2012
Key facts
- NPI
- 1902162811
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 360411 (MS)
- Legal business name
- SOUTH DELTA DENTAL CLINIC, LLC
- Practice address
- 21 S Fourth St
Rolling Fork, MS 39159-5146 - Phone
- (662) 873-5170
- NPI assigned
- Apr 4, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Michael Murphy
- Title
- Chief Operating Officer
- Phone
- (601) 955-7970
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 360411 | MS | Yes |
Addresses
Primary practice location
21 S Fourth St
Rolling Fork, MS 39159-5146
Mailing address
21 S Fourth St
Rolling Fork, MS 39159-5146
Phone (662) 873-5170
Other providers in Rolling Fork, MS
- Sharkey Issaquena Community Hospital
- Sharkey Issaquena Community Hospital
- Sharkey Issaquena Community Hospital
- Sharkey-Issaquena Community Hospital
- Sharkey-Issaquena Community Hospital
- South Delta Medical, PLLC
- Emma Tankson
- Total Body Rehabilitation, LLC.
- Villiage Pharmacy Inc
- Malinda Denise Washington
All providers in Rolling Fork, MS · General Practice Dentistry in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2012. 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.