| Park Place Dental | |
|
403 N Third St Booneville MS 38829-1609 | |
| (662) 728-8171 | |
| (662) 728-1093 |
| Full Name | Park Place Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 403 N Third St, Booneville, Mississippi |
| Authorized Official Name and Position | Ken G Goodwin (OWNER) |
| Authorized Official Contact | 6627288171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Place Dental 403 N Third St Booneville MS 38829-1609 Ph: (662) 728-8171 | Park Place Dental 403 N Third St Booneville MS 38829-1609 Ph: (662) 728-8171 |
| NPI Number | 1548673320 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 06/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548673320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1971-82 (Mississippi) | Primary |
Charles D. Johnson, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 W Church St, Booneville, MS 38829 Phone: 662-728-8133 Fax: 662-728-6903 | |
Downs Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Second St, Booneville, MS 38829 Phone: 662-728-1999 | |
Catherine Johnson Mincy, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 607 W Church St, Booneville, MS 38829 Phone: 662-728-8133 Fax: 662-728-6903 | |
Booneville General Dentistry, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 507 E Church St, Booneville, MS 38829 Phone: 662-728-2123 Fax: 662-728-1748 |