Oral & Maxillofacial Surgery Clinic of South Misssissippi, P.a.
NPI #1578596060 in Hattiesburg, Mississippi
Provider Information
- NPI Number
- 1578596060
- Entity Type
- Organization
- Organization Name
- Oral & Maxillofacial Surgery Clinic of South Misssissippi, P.a.
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Jul 8, 2006
- Last Updated
- Jul 22, 2020
Practice Location
- Address
- 1421 S 28TH AVE
- City
- Hattiesburg
- State
- Mississippi
- ZIP Code
- 39402-3108
- Phone
- (601) 264-7611
Authorized Official
- Name
- MRS. SANDRA P ODOM
- Title
- ADMINISTRATOR
- Phone
- (601) 261-9317
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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