Organization · Type 2 NPI

Reservoir Smiles Dentistry, PLLC

Dental Clinic/Center · Brandon, MS

NPI number 1316458136 Active

Practice location

1149 Old Fannin Rd Ste 26
Brandon, MS 39047-9244

Call (601) 992-7972 Map

Fax (601) 992-7975

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000X3421 (MS)

Dental Clinic/Center: Definition to come...

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About NPI 1316458136

Reservoir Smiles Dentistry, PLLC's National Provider Identifier is 1316458136, issued on Oct 19, 2017. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Brandon, MS. The record was last updated on Oct 19, 2017.