NETTLETON DENTAL LLC NPI 1780303677

NPI Information

  • NPI: 1780303677
  • Provider Name: NETTLETON DENTAL LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 228 MAIN ST
    NETTLETON, MS
    ZIP 38858
  • Phone: (662) 963-7338

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NPI Details

NETTLETON DENTAL LLC is a dental clinic center in Nettleton, MS. NETTLETON DENTAL LLC NPI is 1780303677. The provider is registered as an organization entity type.

The provider's business location address is:

228 MAIN ST
NETTLETON, MS
ZIP 38858-012
Phone: (662) 963-7338

The provider's authorized official is Ambrie Goodman .
The authorized official title is Dentist and has the following contact phone number (662) 571-8760.

The enumeration date for this NPI number is 8/24/2022 and was last updated on 8/24/2022.

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
1261QD0000XClinic/CenterDentalYes

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: 11/21/2025

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