Back Bay Family Dentistry is a Dental Clinic in Diberville, Mississippi. It is located at 10409 Boney Ave, Diberville, MS and its contact number is 228-392-0509. The authorized person for Back Bay Family Dentistry is Jeremy W Parker
who is Owner of the clinic and their contact number is 228-392-0509. Other organizations associated with this clinic are Steven K Miner, Back Bay Family Dentistry, Collin B Peterson Dmd Dentistry Pllc, The primary license number for Back Bay Family Dentistry is 3553-10 (General Practice) in Mississippi.
Back Bay Family Dentistry Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Back Bay Family Dentistry Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Back Bay Family Dentistry |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 10409 Boney Ave, Diberville,
Mississippi, 39540-4813 |
| Phone: | 228-392-0509 |
| Fax: | 228-392-8709 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Jeremy W Parker |
| Position: | Owner |
| Contact Number: | 228-392-0509 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Back Bay Family Dentistry clinic are as mentioned below.
| NPI Number: | 1316306988 |
| NPI Enumeration Date: | 11 Feb, 2016 |
| NPI Last Update On: | 11 Feb, 2016 |
Other Associated Organizations:
Other organizations which are associated with this clinic are as mentioned below. These organization share the same address but have similar or different specialization.
Speciality of these organizations are also mentioned below.
| Name | Specialization | NPI Number |
| Steven K Miner | Dentistry | 1023485851 |
| Back Bay Family Dentistry | General Practice Dentistry | 1316306988 |
| Collin B Peterson Dmd Dentistry Pllc | General Practice Dentistry | 1447059019 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Back Bay Family Dentistry are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | 3553-10 | Mississippi | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 09424204 | Medicaid | Mississippi | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Back Bay Family Dentistry
10409 Boney Ave,
Diberville, Mississippi |
| Zip: | 39540-4813 |
| Phone Number: | 228-392-0509 |
| Fax Number: | 228-392-8709 |
Patients can reach Back Bay Family Dentistry at
10409 Boney Ave, Diberville, Mississippi or can
call to book an appointment on 228-392-0509.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.