| Chickasaw Dental Group L. L. C. | |
|
327 N Jackson St Houston MS 38851 | |
| (662) 456-9992 | |
| (662) 456-9093 |
| Full Name | Chickasaw Dental Group L. L. C. |
|---|---|
| Speciality | Dentist |
| Location | 327 N Jackson St, Houston, Mississippi |
| Authorized Official Name and Position | Teena Freeman Horn (DENTIST OWNER) |
| Authorized Official Contact | 6624569992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chickasaw Dental Group L. L. C. Po Box 604 Houston MS 38851 Ph: (662) 456-9992 | Chickasaw Dental Group L. L. C. 327 N Jackson St Houston MS 38851 Ph: (662) 456-9992 |
| NPI Number | 1134212038 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 12/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134212038 | NPI | - | NPPES |
| 09016032 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |