| Fdc Of Laurel Llc | |
|
1532 W 15th St Laurel MS 39440-2102 | |
| (601) 428-0082 | |
| Not Available |
| Full Name | Fdc Of Laurel Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1532 W 15th St, Laurel, Mississippi |
| Authorized Official Name and Position | Shelley S. Taylor (OWNER/DENTIST) |
| Authorized Official Contact | 6014280082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fdc Of Laurel Llc Po Box 6505 Laurel MS 39441-6505 Ph: (601) 428-0082 | Fdc Of Laurel Llc 1532 W 15th St Laurel MS 39440-2102 Ph: (601) 428-0082 |
| NPI Number | 1124599105 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124599105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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