Organization · Type 2 NPI
Leaf River Dental, PLLC
Dental Clinic/Center · Petal, MS
NPI number
1750906707
Active
Practice location
1115 Evelyn Gandy Parkway
Petal, MS 39465
Mailing address
4358 Lincoln Road Ext Ste 20
Hattiesburg, MS 39402-3275
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1750906707
Leaf River Dental, PLLC's National Provider Identifier is 1750906707, issued on Jun 15, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Petal, MS. The record was last updated on Jun 15, 2020.