Center Avenue Dental Care, LLC

NPI #1710127311 in Sumrall, Mississippi

Provider Information

NPI Number
1710127311
Entity Type
Organization
Organization Name
Center Avenue Dental Care, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
BISHOP & BASS, P.A.
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 23, 2009
Last Updated
Feb 23, 2009

Practice Location

Address
90 CENTER AVE
ZIP Code
39482-5002
Phone
(601) 758-3535

Authorized Official

Name
DR. ROGER KYLE BASS, D.M.D.
Title
PRESIDENT
Phone
(601) 765-4355

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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