Reservoir Smiles Dentistry, Pllc
NPI #1316458136 in Brandon, Mississippi
Provider Information
- NPI Number
- 1316458136
- Entity Type
- Organization
- Organization Name
- Reservoir Smiles Dentistry, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- HALL FAMILY DENTISTRY
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 19, 2017
- Last Updated
- Oct 19, 2017
Practice Location
- Address
- 1149 OLD FANNIN RD STE 26
- City
- Brandon
- State
- Mississippi
- ZIP Code
- 39047-9244
- Phone
- (601) 992-7972
Authorized Official
- Name
- DR. AMYE LEE SHAMBURGER, DMD
- Title
- OWNER
- Phone
- (769) 798-3909
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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