Choctaw Health Center Dental | |
210 Hospital Cir Choctaw MS 39350-6781 | |
(601) 389-6342 | |
(601) 663-7721 |
Full Name | Choctaw Health Center Dental |
---|---|
Speciality | Dentist |
Location | 210 Hospital Cir, Choctaw, Mississippi |
Authorized Official Name and Position | Phyllis J Anderson (TRIBAL CHIEF) |
Authorized Official Contact | 6016565251 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Choctaw Health Center Dental 210 Hospital Cir Choctaw MS 39350-6781 Ph: (601) 389-6342 | Choctaw Health Center Dental 210 Hospital Cir Choctaw MS 39350-6781 Ph: (601) 389-6342 |
NPI Number | 1073715579 |
---|---|
Provider Enumeration Date | 06/05/2007 |
Last Update Date | 06/15/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073715579 | NPI | - | NPPES |
9013488 | Medicaid | MS | |
000010359 | Other | MS | BC BS DENTAL PROVIDER NUM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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