Healthcare Provider Details

I. General information

NPI: 1205767217
Provider Name (Legal Business Name): MICHAEL LEE VOLK DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N ROBINSON ST
SENATOBIA MS
38668-2149
US

IV. Provider business mailing address

108 CHERRY BLUFF DR
MADISON MS
39110-7562
US

V. Phone/Fax

Practice location:
  • Phone: 662-562-9484
  • Fax:
Mailing address:
  • Phone: 601-201-1394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112670
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: