| Sky Family Dental, Llc | |
|
200 Meadowlane Street Eupora MS 39744 | |
| (662) 744-7040 | |
| (662) 744-7046 |
| Full Name | Sky Family Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 Meadowlane Street, Eupora, Mississippi |
| Authorized Official Name and Position | Dustin G. Smith (OWNER) |
| Authorized Official Contact | 6012979082 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sky Family Dental, Llc 200 Meadowlane Street Eupora MS 39744 Ph: (662) 744-7040 | Sky Family Dental, Llc 200 Meadowlane Street Eupora MS 39744 Ph: (662) 744-7040 |
| NPI Number | 1255991196 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 06/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255991196 | NPI | - | NPPES |
| 00660344 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Stephen S. Wooten Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 Meadowlane St, Eupora, MS 39744 Phone: 662-258-2461 |