| Meridian Pediatric Dental Group, Llc | |
|
1922 23rd Ave Meridian MS 39301 | |
| (601) 482-8986 | |
| (601) 482-6100 |
| Full Name | Meridian Pediatric Dental Group, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1922 23rd Ave, Meridian, Mississippi |
| Authorized Official Name and Position | Shelley Wilkerson Ellis (PEDIATRIC DENTIST) |
| Authorized Official Contact | 6014828986 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Pediatric Dental Group, Llc 1922 23rd Ave Meridian MS 39301 Ph: (601) 482-8986 | Meridian Pediatric Dental Group, Llc 1922 23rd Ave Meridian MS 39301 Ph: (601) 482-8986 |
| NPI Number | 1356606511 |
|---|---|
| Provider Enumeration Date | 07/12/2012 |
| Last Update Date | 07/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356606511 | NPI | - | NPPES |
| 00060313 | Medicaid | MS | |
| 01035561 | Other | MS | SWE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Mississippi) | Primary |
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Esthetics Unlimited Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2400 16th St, Meridian, MS 39301 Phone: 601-483-6021 Fax: 601-483-1140 | |
North Hills Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 N Hills St, Meridian, MS 39305 Phone: 601-485-4851 Fax: 601-693-5936 | |
Ferrell Fort Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1903 23rd Ave, Meridian, MS 39301 Phone: 601-485-2494 | |
Shelley W. Mcdonald, Dmd, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1922 23rd Ave, Meridian, MS 39301 Phone: 601-482-8986 Fax: 601-482-6100 | |
Charles E Atkins Jr, Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1603 23rd Ave, Meridian, MS 39301 Phone: 601-483-4522 Fax: 601-485-9925 | |
Brock B. Westover Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1927 23rd Ave, Meridian, MS 39301 Phone: 601-693-3009 Fax: 601-693-3010 | |
J A Lauderdale Iii, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2321 16th St, Meridian, MS 39301 Phone: 601-693-4544 |