| My Vicksburg Dentist | |
|
1805 Mission 66 Vicksburg MS 39180-3709 | |
| (601) 638-2361 | |
| (601) 634-0864 |
| Full Name | My Vicksburg Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1805 Mission 66, Vicksburg, Mississippi |
| Authorized Official Name and Position | Kim Wilson (CRED. SUPERVISOR) |
| Authorized Official Contact | 2175405170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Vicksburg Dentist 1805 Mission 66 Vicksburg MS 39180-3709 Ph: (601) 638-2361 | My Vicksburg Dentist 1805 Mission 66 Vicksburg MS 39180-3709 Ph: (601) 638-2361 |
| NPI Number | 1962831719 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 11/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962831719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Margo R Marveggio Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Mission 66, Vicksburg, MS 39183 Phone: 601-636-6081 | |
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