| Delta Corner Properties, LLC | |
|
201 W Sunflower Rd Cleveland MS 38732-2637 | |
| (601) 271-8710 | |
| Not Available |
| Full Name | Delta Corner Properties, LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 201 W Sunflower Rd, Cleveland, Mississippi |
| Authorized Official Name and Position | Lanthea Mangum (COO) |
| Authorized Official Contact | 6012718710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Corner Properties, LLC 4358 Lincoln Road Ext Ste 20 Hattiesburg MS 39402-3275 Ph: (601) 271-8710 | Delta Corner Properties, LLC 201 W Sunflower Rd Cleveland MS 38732-2637 Ph: (601) 271-8710 |
| NPI Number | 1952926933 |
|---|---|
| Provider Enumeration Date | 06/15/2020 |
| Last Update Date | 06/15/2020 |
| Certification Date | 06/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952926933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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