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Roderick L. Coleman, D.m.d., Pa
Pediatric Dentist in Vicksburg, Mississippi
NPI 1962686394

Roderick L. Coleman, D.m.d., Pa is a Pediatric Dentist based in Vicksburg, MS and is specialized in Pediatric Dentistry. Roderick L. Coleman, D.m.d., Pa practices in Vicksburg, MS. The NPI Number for Roderick L. Coleman, D.m.d., Pa is 1962686394 and holds a License No. 315300 (Mississippi).

The current practice location address for Roderick L. Coleman, D.m.d., Pa is 120 Holt Collier Dr, Vicksburg, MS and can be reached out via phone at 601-619-4777 and via fax at 601-619-4667.

Location: 120 Holt Collier Dr, Vicksburg, MS, 39183-4408
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962686394
Provider Name
Roderick L. Coleman, D.m.d., Pa
Credential
Provider Entity Type
Organization
Address
120 Holt Collier Dr, Vicksburg, MS, 39183-4408
Phone Number
601-619-4777
Fax Number
601-619-4667
Provider Enumeration Date
12/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02988820 05 MS
institution
Provider Business Practice Location Address Details
Address
120 Holt Collier Dr
City
Vicksburg
State
Mississippi
Zip
39183-4408
Phone Number
601-619-4777
Fax Number
601-619-4667
person
Provider Business Mailing Address Details
Address
120 Holt Collier Dr
City
Vicksburg
State
Mississippi
Zip
39183-4408
Phone Number
601-619-4777
Fax Number
601-619-4667
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
315300 (Mississippi)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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