PERIODONTAL ASSOCIATES OF JACKSON P.A. NPI 1790069854

NPI Information

PERIODONTAL ASSOCIATES OF JACKSON, P.A. is a periodontics dentist in Jackson, MS. The provider is 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. PERIODONTAL ASSOCIATES OF JACKSON, P.A. NPI is 1790069854. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

406 BRIARWOOD DR.
STE. 101
JACKSON, MS
ZIP 39206
Phone: (601) 956-1230
Fax: (601) 956-0201

The provider's authorized official is Roger B. Parkes .
The authorized official title is Owner/dentist and has the following contact phone number (601) 956-1230.

The enumeration date for this NPI number is 10/6/2011 and was last updated on 10/6/2011.

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:

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