Healthcare Provider Details

I. General information

NPI: 1982859047
Provider Name (Legal Business Name): JOYCE A HYDE DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 HIGHWAY 49 S STE C
RICHLAND MS
39218-7517
US

IV. Provider business mailing address

1055 HIGHWAY 49 S STE C
RICHLAND MS
39218-7517
US

V. Phone/Fax

Practice location:
  • Phone: 601-664-6655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number3389-06
License Number StateMS

VIII. Authorized Official

Name: DR. JOYCE A HYDE
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 601-664-6655