| Kimberly Blair Smith Dmd Pa | |
|
409 Main St N Mendenhall MS 39114-3318 | |
| (601) 847-1223 | |
| (601) 847-9131 |
| Full Name | Kimberly Blair Smith Dmd Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 409 Main St N, Mendenhall, Mississippi |
| Authorized Official Name and Position | Kimberly Blair Smith (PRESIDENT) |
| Authorized Official Contact | 6018471223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Blair Smith Dmd Pa 409 Main St N Mendenhall MS 39114-3318 Ph: (601) 847-1223 | Kimberly Blair Smith Dmd Pa 409 Main St N Mendenhall MS 39114-3318 Ph: (601) 847-1223 |
| NPI Number | 1891842332 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891842332 | NPI | - | NPPES |
| 09015751 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 3186-01 (Mississippi) | Primary |
Simpson Dental Group Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1827 Simpson Highway 149, Ste C, Mendenhall, MS 39114 Phone: 601-847-2100 Fax: 601-847-3111 |