Columbia Family Dental LLC
Organization Active NPI Dentist · Columbia, MS
NPI 1912475922 · NPPES record last updated Nov 7, 2018
Key facts
- NPI
- 1912475922
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- COLUMBIA FAMILY DENTAL LLC
- Practice address
- 430 Broad St
Columbia, MS 39429-3006 - Phone
- (601) 543-6510
- NPI assigned
- Nov 7, 2018
- Organization subpart
- Yes
- Parent organization (as reported)
- MICHAEL C HUMPHREYS
Authorized official
- Name
- Mrs. Tammy Lowry
- Title
- Office Manager
- Phone
- (601) 543-6510
National Provider Directory
- Part of
- Columbia Family Dental LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes |
Addresses
Primary practice location
430 Broad St
Columbia, MS 39429-3006
Mailing address
430 Broad St
Columbia, MS 39429-3006
Phone (601) 543-6510
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08902788 | Medicaid | MS |
Other names
- Humphreys Family Dental
Other providers in Columbia, MS
- Children'S International, LLC
- Cody Caston Choate
- Steven Alan Clement
- Columbia Community Care Center LLC
- Columbia Discount Drugs, Inc
- Columbia Pediatris, P.C.
- Columbia Rehabilitation and Healthcare Center, LLC
- Columbia Rehabilitation LLC
- Columbia School District
- Compassionate Heart Personal Care & Respite Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2018. 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.