Wren Pediatric Dentistry, Pllc | |
1390 W Government St Suite B Brandon MS 39042-3272 | |
(601) 824-0093 | |
(601) 825-0240 |
Full Name | Wren Pediatric Dentistry, Pllc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 1390 W Government St, Brandon, Mississippi |
Authorized Official Name and Position | Josh Wren (OWNER) |
Authorized Official Contact | 6018240093 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wren Pediatric Dentistry, Pllc 1390 W Government St Suite B Brandon MS 39042-3272 Ph: (601) 824-0093 | Wren Pediatric Dentistry, Pllc 1390 W Government St Suite B Brandon MS 39042-3272 Ph: (601) 824-0093 |
NPI Number | 1235339284 |
---|---|
Provider Enumeration Date | 07/18/2007 |
Last Update Date | 07/18/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235339284 | NPI | - | NPPES |
07707591 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | PEDO-402-07 (Mississippi) | Primary |
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