Vicksburg Family Dental

LBN: Vicksburg Family Dental
Vicksburg Family Dental is an health care organization with primary practice located at 1212 Mission 66 , Vicksburg MS 39183. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Vicksburg Family Dental can be contacted via phone (601) 636-5321, or through Garner, Terry Lake via phone (601) 636-5321.

Contact Information

Primary practice address
1212 Mission 66 Vicksburg MS 39183
Phone: (601) 636-5321
Fax: (601) 883-2366
Website:
Map and Directions
Authorized official contact:
Name: Garner, Terry Lake Doctor of Dental Medicine (DMD)
Phone: (601) 636-5321

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2940-96MS Mississippi

Profile Details

NPI number 1235497108
LBN Legal business name Vicksburg Family Dental
DBA Doing business as
Authorized official Garner, Terry Lake Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 30th, 2012
Last updated Apr 30th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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