Canton Communitydentalclinicllc is a Dental Clinic in Canton, Mississippi. It is located at 512 W Fulton St, Canton, MS and its contact number is 601-855-5885. The authorized person for Canton Communitydentalclinicllc is Dr. Timothy Terell Johnson
who is Dentist of the clinic and their contact number is 601-855-5885. The primary license number for Canton Communitydentalclinicllc is 3108-99 (General Practice) in Mississippi.
Canton Communitydentalclinicllc 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:
Canton Communitydentalclinicllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Canton Communitydentalclinicllc |
| Specialization: | General Practice Dentistry |
| Clinic Address: | 512 W Fulton St, Canton,
Mississippi, 39046-4254 |
| Phone: | 601-855-5885 |
| Fax: | 601-855-2833 |
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: | Dr. Timothy Terell Johnson |
| Position: | Dentist |
| Contact Number: | 601-855-5885 |
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 Canton Communitydentalclinicllc clinic are as mentioned below.
| NPI Number: | 1568567477 |
| NPI Enumeration Date: | 14 Sep, 2006 |
| NPI Last Update On: | 22 Aug, 2020 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Canton Communitydentalclinicllc are as mentioned below.
| Specialization | License Number | State | Status | |
| General Practice | 3108-99 | 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 |
| 08324092 | 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: | Canton Communitydentalclinicllc
512 W Fulton St,
Canton, Mississippi |
| Zip: | 39046-4254 |
| Phone Number: | 601-855-5885 |
| Fax Number: | 601-855-2833 |
Patients can reach Canton Communitydentalclinicllc at
512 W Fulton St, Canton, Mississippi or can
call to book an appointment on 601-855-5885.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.