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Leaf River Dental, Pllc
Dental Clinic/Center in Petal, Mississippi
NPI 1750906707

Leaf River Dental, Pllc is a Dental Clinic/Center based in Hattiesburg, MS and is specialized in Dental. Leaf River Dental, Pllc practices in Petal, MS. The NPI Number for Leaf River Dental, Pllc is 1750906707 and holds a License No. (Mississippi).

The current practice location address for Leaf River Dental, Pllc is 1115 Evelyn Gandy Parkway, Petal, MS and can be reached out via phone at 601-271-8710.

Location: 1115 Evelyn Gandy Parkway, Petal, MS, 39402-3275
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750906707
Provider Name
Leaf River Dental, Pllc
Credential
Provider Entity Type
Organization
Address
1115 Evelyn Gandy Parkway, Petal, MS, 39402-3275
Phone Number
601-271-8710
Fax Number
Provider Enumeration Date
06/15/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1115 Evelyn Gandy Parkway
City
Petal
State
Mississippi
Zip
39465
Phone Number
601-271-8710
Fax Number
person
Provider Business Mailing Address Details
Address
1115 Evelyn Gandy Parkway
City
Petal
State
Mississippi
Zip
39465
Phone Number
601-271-8710
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
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Definition
Definition to come...
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