| Children's Dental Center | |
|
1150 Monteith Avenue Suite 102 Hernando MS 38632 | |
| (662) 298-2095 | |
| Not Available |
| Full Name | Children's Dental Center |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1150 Monteith Avenue, Hernando, Mississippi |
| Authorized Official Name and Position | Jason Coleman (OWNER) |
| Authorized Official Contact | 6622982095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Center 1150 Monteith Avenue Suite 102 Hernando MS 38632 Ph: (662) 298-2095 | Children's Dental Center 1150 Monteith Avenue Suite 102 Hernando MS 38632 Ph: (662) 298-2095 |
| NPI Number | 1669850004 |
|---|---|
| Provider Enumeration Date | 05/18/2015 |
| Last Update Date | 05/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669850004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | PEDO 359 02 (Mississippi) | Primary |
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