PEDIATRIC DENTISTRY P.A. NPI 1134414733

NPI Information

PEDIATRIC DENTISTRY, P.A. is a pediatric dentistry dentist in Jackson, MS. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC DENTISTRY, P.A. NPI is 1134414733. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5315 HIGHWAY 18 W
JACKSON, MS
ZIP 39209-421
Phone: (601) 922-0066
Fax: (601) 922-0077

The provider's authorized official is L Lee Cope .
The authorized official title is Dentist and has the following contact phone number (601) 922-0066.

The enumeration date for this NPI number is 6/13/2011 and was last updated on 6/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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