Provider Demographics
NPI:1871691725
Name:DENTAL SOLUTIONS OF MISSISSIPPI P.A.
Entity type:Organization
Organization Name:DENTAL SOLUTIONS OF MISSISSIPPI P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-859-2182
Mailing Address - Street 1:1309 E PEACE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-4956
Mailing Address - Country:US
Mailing Address - Phone:601-859-2182
Mailing Address - Fax:601-859-9346
Practice Address - Street 1:1309 E PEACE ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-4956
Practice Address - Country:US
Practice Address - Phone:601-859-2182
Practice Address - Fax:601-859-9346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMS202683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty