Columbia Family Dental LLC

NPI #1912475922 in Columbia, Mississippi

Provider Information

NPI Number: 1912475922
Entity Type: Organization
Organization Name: Columbia Family Dental LLC
Subpart: Yes (part of a larger organization)
Parent Organization: MICHAEL C HUMPHREYS
Primary Specialty: Dentist
Enumeration Date: Nov 7, 2018
Last Updated: Nov 7, 2018

Practice Location

Address: 430 BROAD ST
City: Columbia
State: Mississippi
ZIP Code: 39429-3006
Phone: (601) 543-6510

Authorized Official

Name: MRS. TAMMY LOWRY
Title: OFFICE MANAGER
Phone: (601) 543-6510

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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