Roderick L. Coleman, D.m.d., Pa
Pediatric Dental Clinic
120 Holt Collier Dr, Suite D, Vicksburg
Mississippi, 39183-4408
601-619-4777 601-619-4667
Maps & DirectionsRoderick L. Coleman, D.m.d., Pa is a Pediatric Dental Clinic in Vicksburg, Mississippi. It is located at 120 Holt Collier Dr, Suite D, Vicksburg, MS and its contact number is 601-619-4777. The authorized person for Roderick L. Coleman, D.m.d., Pa is Dr. Roderick L Coleman
who is Owner of the clinic and their contact number is 601-619-4777. The primary license number for Roderick L. Coleman, D.m.d., Pa is 315300 (Pediatric Dentistry) in Mississippi.
Roderick L. Coleman, D.m.d., Pa Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Roderick L. Coleman, D.m.d., Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Roderick L. Coleman, D.m.d., Pa |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 120 Holt Collier Dr, Suite D, Vicksburg,
Mississippi, 39183-4408 |
| Phone: | 601-619-4777 |
| Fax: | 601-619-4667 |
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. Roderick L Coleman |
| Position: | Owner |
| Contact Number: | 601-619-4777 |
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 Roderick L. Coleman, D.m.d., Pa clinic are as mentioned below.
| NPI Number: | 1962686394 |
| NPI Enumeration Date: | 20 Dec, 2007 |
| NPI Last Update On: | 20 Dec, 2007 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Roderick L. Coleman, D.m.d., Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 315300 | 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 |
| 02988820 | 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: | Roderick L. Coleman, D.m.d., Pa
120 Holt Collier Dr, Suite D
Vicksburg, Mississippi |
| Zip: | 39183-4408 |
| Phone Number: | 601-619-4777 |
| Fax Number: | 601-619-4667 |
Patients can reach Roderick L. Coleman, D.m.d., Pa at
120 Holt Collier Dr, Suite D, Vicksburg, Mississippi or can
call to book an appointment on 601-619-4777.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.