| Ware Family Dental | |
|
2376 Sunset Dr Grenada MS 38901-2827 | |
| (662) 226-1865 | |
| (662) 226-1845 |
| Full Name | Ware Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2376 Sunset Dr, Grenada, Mississippi |
| Authorized Official Name and Position | Latonya Ware (OWNER/OPERATOR) |
| Authorized Official Contact | 6622261865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ware Family Dental 2376 Sunset Dr Grenada MS 38901-2827 Ph: (662) 226-1865 | Ware Family Dental 2376 Sunset Dr Grenada MS 38901-2827 Ph: (662) 226-1865 |
| NPI Number | 1568626489 |
|---|---|
| Provider Enumeration Date | 07/10/2008 |
| Last Update Date | 09/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568626489 | NPI | - | NPPES |
| 09304801 | Medicaid | MS | |
| 08557260 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 336906 (Mississippi) | Primary |
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