Ellisville State School Dental is a Dental Clinic in Ellisville, Mississippi. It is located at 1101 Highway 11 S, Ellisville, MS and its contact number is 601-477-9384. The authorized person for Ellisville State School Dental is Suzie Lassiter
who is Director Of Facility of the clinic and their contact number is 601-477-9384. The primary license number for Ellisville State School Dental is 09013809 (Dentist) in Mississippi. Ellisville State School Dental Clinic have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
Complete Clinic Profile:
Ellisville State School Dental Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
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:
Suzie Lassiter
Position:
Director Of Facility
Contact Number:
601-477-9384
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 Ellisville State School Dental clinic are as mentioned below.
NPI Number:
1013085414
NPI Enumeration Date:
01 Dec, 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 Ellisville State School Dental are as mentioned below.
Specialization
License Number
State
Status
Dentist
09013809
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
09013809
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:
Ellisville State School Dental 1101 Highway 11 S, Ellisville, Mississippi
Zip:
39437-4443
Phone Number:
601-477-9384
Fax Number:
601-477-5700
Patients can reach Ellisville State School Dental at 1101 Highway 11 S, Ellisville, Mississippi or can call to book an appointment on 601-477-9384. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.