| Roderick L. Coleman, D.m.d., Pa | |
|
120 Holt Collier Dr Suite D Vicksburg MS 39183-4408 | |
| (601) 619-4777 | |
| (601) 619-4667 |
| Full Name | Roderick L. Coleman, D.m.d., Pa |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 120 Holt Collier Dr, Vicksburg, Mississippi |
| Authorized Official Name and Position | Roderick L Coleman (OWNER) |
| Authorized Official Contact | 6016194777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roderick L. Coleman, D.m.d., Pa 120 Holt Collier Dr Suite D Vicksburg MS 39183-4408 Ph: (601) 619-4777 | Roderick L. Coleman, D.m.d., Pa 120 Holt Collier Dr Suite D Vicksburg MS 39183-4408 Ph: (601) 619-4777 |
| NPI Number | 1962686394 |
|---|---|
| Provider Enumeration Date | 12/20/2007 |
| Last Update Date | 12/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962686394 | NPI | - | NPPES |
| 02988820 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 315300 (Mississippi) | Primary |
Janet S Fisher Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Southern Oral And Maxillofacial Surgery Center, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1205 Mission Park Dr, Vicksburg, MS 39180 Phone: 601-661-0034 Fax: 601-661-0367 | |
Delta Orthodontic Specialists Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2356 Grove Street, Vicksburg, MS 39183 Phone: 601-638-8230 Fax: 601-636-3388 | |
Jackson Hinds Comprehensive Health Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3312 Oak St, Vicksburg, MS 39180 Phone: 601-629-9500 Fax: 601-638-9044 | |
Margo R Marveggio Dmd Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1011 Mission 66, Vicksburg, MS 39183 Phone: 601-636-6081 | |
Vicksburg Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Mission 66, Vicksburg, MS 39183 Phone: 601-636-5321 Fax: 601-883-2366 | |
Robert A. Sadler Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1016 Mission 66, Vicksburg, MS 39183 Phone: 601-638-3661 |