Dental Group Of Ellisville, Pllc is a Dental Clinic in Ellisville, Mississippi. It is located at 97 Hal Crocker Road, Ellisville, MS and its contact number is 601-477-3779. The authorized person for Dental Group Of Ellisville, Pllc is Terry Lake Garner
who is Owner of the clinic and their contact number is 601-271-8710. The primary license number for Dental Group Of Ellisville, Pllc is 2940-96 (General Practice) in Mississippi. Dental Group Of Ellisville, Pllc 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:
Dental Group Of Ellisville, Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Dental Group Of Ellisville, Pllc
Specialization:
General Practice Dentistry
Clinic Address:
97 Hal Crocker Road, Ellisville, Mississippi, 39437
Phone:
601-477-3779
Fax:
601-477-3770
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:
Terry Lake Garner
Position:
Owner
Contact Number:
601-271-8710
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 Dental Group Of Ellisville, Pllc clinic are as mentioned below.
NPI Number:
1972851814
NPI Enumeration Date:
27 Aug, 2012
NPI Last Update On:
18 Mar, 2019
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dental Group Of Ellisville, Pllc are as mentioned below.
Specialization
License Number
State
Status
General Practice
2940-96
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
00660377
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:
Dental Group Of Ellisville, Pllc 97 Hal Crocker Road, Ellisville, Mississippi
Zip:
39437
Phone Number:
601-477-3779
Fax Number:
601-477-3770
Patients can reach Dental Group Of Ellisville, Pllc at 97 Hal Crocker Road, Ellisville, Mississippi or can call to book an appointment on 601-477-3779. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.