Organization · Type 2 NPI

Dental Professionals of Mississippi, P.c.

General Practice Dentistry · Vicksburg, MS

NPI number 1962831719 Active

Practice location

1805 Mission 66
Vicksburg, MS 39180-3709

Fax (601) 634-0864

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

3 other providers at this address

Other general practice dentistry providers in Vicksburg

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NPI record

NPI: 1962831719
Entity type: Organization (Type 2)
Issued: Nov 2, 2013
Last updated: Nov 2, 2013
Status: Active
Subpart: Yes of Dental Professionals of Mississippi, P.c.

Other names

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My Vicksburg Dentist · doing business as

Authorized official

Kim Wilson
Cred. Supervisor
(217) 540-5170

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962831719

Dental Professionals of Mississippi, P.c.'s National Provider Identifier is 1962831719, issued on Nov 2, 2013. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Vicksburg, MS. The record was last updated on Nov 2, 2013.