| Grants Ferry Family Dentistry | |
|
1075 Lake Village Cir Brandon MS 39047-6743 | |
| (601) 992-1605 | |
| Not Available |
| Full Name | Grants Ferry Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1075 Lake Village Cir, Brandon, Mississippi |
| Authorized Official Name and Position | Erin Green (OWNER) |
| Authorized Official Contact | 6018502145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grants Ferry Family Dentistry 1075 Lake Village Cir Brandon MS 39047-6743 Ph: (601) 850-2145 | Grants Ferry Family Dentistry 1075 Lake Village Cir Brandon MS 39047-6743 Ph: (601) 992-1605 |
| NPI Number | 1609492750 |
|---|---|
| Provider Enumeration Date | 06/24/2020 |
| Last Update Date | 06/24/2020 |
| Certification Date | 06/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609492750 | NPI | - | NPPES |
| 1699113365 | Other | MS | NPI |
| 1669810040 | Other | LA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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