| Yazoo City Dental Clinic | |
|
1615 Easy Street Yazoo MS 39194-2427 | |
| (662) 746-1432 | |
| (662) 746-5974 |
| Full Name | Yazoo City Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1615 Easy Street, Yazoo, Mississippi |
| Authorized Official Name and Position | William Newman Nelson (OWNER) |
| Authorized Official Contact | 6627461432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Yazoo City Dental Clinic 1615 Easy Street Yazoo MS 39194-2427 Ph: (662) 746-1432 | Yazoo City Dental Clinic 1615 Easy Street Yazoo MS 39194-2427 Ph: (662) 746-1432 |
| NPI Number | 1871622753 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871622753 | NPI | - | NPPES |
| 09015614 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |