| Central Mississippi Outreach, Llc | |
|
2160 D Newman Rd Utica MS 39175-9039 | |
| (601) 214-3041 | |
| Not Available |
| Full Name | Central Mississippi Outreach, Llc |
|---|---|
| Speciality | Dentist |
| Location | 2160 D Newman Rd, Utica, Mississippi |
| Authorized Official Name and Position | Robert J Hauptman (PARTNER) |
| Authorized Official Contact | 6012143041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Mississippi Outreach, Llc 2160 D Newman Rd Utica MS 39175-9039 Ph: (601) 214-3041 | Central Mississippi Outreach, Llc 2160 D Newman Rd Utica MS 39175-9039 Ph: (601) 214-3041 |
| NPI Number | 1871915397 |
|---|---|
| Provider Enumeration Date | 01/17/2014 |
| Last Update Date | 01/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871915397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3581-11 (Mississippi) | Primary |
Central Mississippi Civic Imrovement Association Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6608 Highway 27, Utica, MS 39175 Phone: 601-882-6021 Fax: 601-885-2268 |