| Childrens Dental Center Hernando LLC | |
|
1150 Monteith Ave Ste 102 Hernando MS 38632-8157 | |
| (662) 298-2105 | |
| (205) 419-9104 |
| Full Name | Childrens Dental Center Hernando LLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1150 Monteith Ave Ste 102, Hernando, Mississippi |
| Authorized Official Name and Position | Bryan L Rhoads (OWNER) |
| Authorized Official Contact | 9012589275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens Dental Center Hernando LLC 1150 Monteith Ave Ste 102 Hernando MS 38632-8157 Ph: (662) 298-2105 | Childrens Dental Center Hernando LLC 1150 Monteith Ave Ste 102 Hernando MS 38632-8157 Ph: (662) 298-2105 |
| NPI Number | 1528710761 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Certification Date | 01/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528710761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (NU) | Primary |
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Children's Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 Phone: 662-298-2095 |
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