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Contact Information

MISS-LOU DENTAL LLC
110 HIGHWAY 61 SOUTH
NATCHEZ, MS39120
 Phone: 318-757-4561
 Fax: 318-757-4595
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MISS-LOU DENTAL LLC

NPI # 1760818017
LBN Legal business name MISS-LOU DENTAL LLC
Authorized official JAMES IVERSTINE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/18/2013
Last updated 09/18/2013 - About 13 years ago
Identifiers
MS License # 3678-12
LA Medicaid 1834190
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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