LD-TUPELO LLC NPI 1760995963

NPI Information

NPI: 1760995963
Provider Name: LD-TUPELO, LLC

Doing Business As: PREMIER DENTAL

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1763 CLIFF GOOKIN BLVD
TUPELO, MS
ZIP 38801
Phone: (662) 842-2802
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LD-TUPELO, LLC is a dental clinic center in Tupelo, MS. LD-TUPELO, LLC NPI is 1760995963. The provider is registered as an organization entity type.
The provider Is Doing Business As Premier Dental.

The provider's business location address is:

1763 CLIFF GOOKIN BLVD
TUPELO, MS
ZIP 38801-723
Phone: (662) 842-2802
Fax: (866) 251-3105

The provider's authorized official is Lauren S Daigneault .
The authorized official title is Admin Director and has the following contact phone number (256) 783-9468.

The enumeration date for this NPI number is 11/9/2017 and was last updated on 7/7/2023.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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