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Back Bay Family Dentistry
General Practice Dentistry in Diberville, Mississippi
NPI 1316306988

Back Bay Family Dentistry is a General Practice Dentistry based in Diberville, MS and is specialized in General Practice. Back Bay Family Dentistry practices in Diberville, MS. The NPI Number for Back Bay Family Dentistry is 1316306988 and holds a License No. 3553-10 (Mississippi).

The current practice location address for Back Bay Family Dentistry is 10409 Boney Ave, Diberville, MS and can be reached out via phone at 228-392-0509 and via fax at 228-392-8709.

Location: 10409 Boney Ave, Diberville, MS, 39540-4813
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316306988
Provider Name
Back Bay Family Dentistry
Credential
Provider Entity Type
Organization
Address
10409 Boney Ave, Diberville, MS, 39540-4813
Phone Number
228-392-0509
Fax Number
228-392-8709
Provider Enumeration Date
02/11/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
09424204 05 MS
institution
Provider Business Practice Location Address Details
Address
10409 Boney Ave
City
Diberville
State
Mississippi
Zip
39540-4813
Phone Number
228-392-0509
Fax Number
228-392-8709
person
Provider Business Mailing Address Details
Address
10409 Boney Ave
City
Diberville
State
Mississippi
Zip
39540-4813
Phone Number
228-392-0509
Fax Number
228-392-8709
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
3553-10 (Mississippi)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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