| Booneville General Dentistry, P.a. | |
|
507 E Church St Booneville MS 38829-3709 | |
| (662) 728-2123 | |
| (662) 728-1748 |
| Full Name | Booneville General Dentistry, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 507 E Church St, Booneville, Mississippi |
| Authorized Official Name and Position | Samuel Robert Hall (PRES) |
| Authorized Official Contact | 6627282123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Booneville General Dentistry, P.a. 507 E Church St Booneville MS 38829-3709 Ph: (662) 728-2123 | Booneville General Dentistry, P.a. 507 E Church St Booneville MS 38829-3709 Ph: (662) 728-2123 |
| NPI Number | 1881073716 |
|---|---|
| Provider Enumeration Date | 05/26/2015 |
| Last Update Date | 05/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881073716 | NPI | - | NPPES |
| 09234892 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3645 12 (Mississippi) | Primary |
Park Place Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 N Third St, Booneville, MS 38829 Phone: 662-728-8171 Fax: 662-728-1093 | |
Charles D. Johnson, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 W Church St, Booneville, MS 38829 Phone: 662-728-8133 Fax: 662-728-6903 | |
Downs Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Second St, Booneville, MS 38829 Phone: 662-728-1999 | |
Catherine Johnson Mincy, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 W Church St, Booneville, MS 38829 Phone: 662-728-8133 Fax: 662-728-6903 |