| Lakeland Dental Care | |
|
11 Lakeland Cir Jackson MS 39216-5006 | |
| (601) 981-8166 | |
| (601) 362-2164 |
| Full Name | Lakeland Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 11 Lakeland Cir, Jackson, Mississippi |
| Authorized Official Name and Position | Bradley J Malley (OWNER) |
| Authorized Official Contact | 6019818166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeland Dental Care 11 Lakeland Cir Jackson MS 39216-5006 Ph: (601) 981-8166 | Lakeland Dental Care 11 Lakeland Cir Jackson MS 39216-5006 Ph: (601) 981-8166 |
| NPI Number | 1750077103 |
|---|---|
| Provider Enumeration Date | 04/17/2023 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750077103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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