Olive Branch Dental Group Pllc
NPI #1174072409 in Olive Branch, Mississippi
Provider Information
- NPI Number
- 1174072409
- Entity Type
- Organization
- Organization Name
- Olive Branch Dental Group Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Sep 28, 2016
- Last Updated
- Sep 28, 2016
Practice Location
- Address
- 7271 GOODMAN RD
- City
- Olive Branch
- State
- Mississippi
- ZIP Code
- 38654-1906
- Phone
- (662) 895-4737
Authorized Official
- Name
- DEBBIE K SHIELDS
- Title
- BUSINESS OFFICE
- Phone
- (662) 840-1535
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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