Quitman Family Dental, Pllc

NPI #1215205331 in Quitman, Mississippi

Provider Information

NPI Number: 1215205331
Entity Type: Organization
Organization Name: Quitman Family Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 3, 2011
Last Updated: Dec 3, 2011

Practice Location

Address: 105 E DONALD ST
City: Quitman
State: Mississippi
ZIP Code: 39355-2342
Phone: (601) 776-2511

Authorized Official

Name: DR. WILLIAM BROCK MARTIN, DMD, JD
Title: DENTIST, PARTNER
Phone: (601) 776-2511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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