Westside Dental, Pllc

NPI #1669596318 in Tupelo, Mississippi

Provider Information

NPI Number: 1669596318
Entity Type: Organization
Organization Name: Westside Dental, Pllc
Primary Specialty: Dentist
Enumeration Date: Mar 19, 2007
Last Updated: Jun 23, 2023

Practice Location

Address: 3694 W JACKSON ST
City: Tupelo
State: Mississippi
ZIP Code: 38801
Phone: (662) 842-8035

Authorized Official

Name: DR. KENNETH LEE AUSTIN, DMD
Title: MANAGER
Phone: (662) 842-8035

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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