| Woodville Dental Care Llc | |
|
211 Highway 61 S Woodville MS 39669-3586 | |
| (601) 888-3090 | |
| (601) 888-3095 |
| Full Name | Woodville Dental Care Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 211 Highway 61 S, Woodville, Mississippi |
| Authorized Official Name and Position | Terry Meneley Devall (PRESIDENT) |
| Authorized Official Contact | 6018883090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodville Dental Care Llc 211 Hwy 61 S Woodville MS 39669-3586 Ph: (601) 888-3090 | Woodville Dental Care Llc 211 Highway 61 S Woodville MS 39669-3586 Ph: (601) 888-3090 |
| NPI Number | 1437443439 |
|---|---|
| Provider Enumeration Date | 06/07/2011 |
| Last Update Date | 06/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437443439 | NPI | - | NPPES |
| 1720276009 | Other | MS | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 228586 (Mississippi) | Primary |