Individual provider · Type 1 NPI
Fanasy Prokop Jefcoat, DMD, MS
Periodontics · Madison, MS
NPI number
1154401909
Active
Practice location
101 Webster Circle, Suite 100
Madison, MS 39110
Fax (601) 605-6508
Mailing address
2044 Tidewater Ln
Madison, MS 39110-8927
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 3251-03 (MS) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
About NPI 1154401909
Fanasy Prokop Jefcoat, DMD, MS's National Provider Identifier is 1154401909, issued on Oct 16, 2006. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Madison, MS. The record was last updated on Feb 7, 2017.