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Contact Information

1ST DENTAL, LLC
313 S 40TH AVE
HATTIESBURG, MS39402-1734
 Phone: 601-264-5100
 Fax: 601-264-6669
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 1ST DENTAL LLC · (Female)

NPI # 1740642834
Status Active
Credentials
Entity Individual
Enumeration date 03/28/2016
Last updated 03/28/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS Medicaid 06680271
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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