| Warren Inge Dental Clinic | |
|
702 Martin Luther King St Mound Bayou MS 38762-9314 | |
| (662) 741-2151 | |
| (662) 741-2700 |
| Full Name | Warren Inge Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 702 Martin Luther King St, Mound Bayou, Mississippi |
| Authorized Official Name and Position | Michelle Porter (ACCOUNTS RECEIVABLE COORDINATOR) |
| Authorized Official Contact | 6627412151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren Inge Dental Clinic 702 Martin Luther King Road Mound Bayou MS 38762-0900 Ph: (662) 741-2151 | Warren Inge Dental Clinic 702 Martin Luther King St Mound Bayou MS 38762-9314 Ph: (662) 741-2151 |
| NPI Number | 1932389467 |
|---|---|
| Provider Enumeration Date | 11/13/2007 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932389467 | NPI | - | NPPES |
| 09013120 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |