Provider First Line Business Practice Location Address:
UNIVERSITY OF MISSISSIPPI SCHOOL OF DENTISTRY
Provider Second Line Business Practice Location Address:
2500 NORTH STATE STREET
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39216-4505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-984-6030
Provider Business Practice Location Address Fax Number:
601-984-6039
Provider Enumeration Date:
09/21/2006