Healthcare Provider Details

I. General information

NPI: 1710051578
Provider Name (Legal Business Name): TERRY ROBERT SCHMUNK D.D.S.,M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3999 N GLOSTER ST STE D
TUPELO MS
38804-0950
US

IV. Provider business mailing address

3999 N GLOSTER ST STE D
TUPELO MS
38804-0950
US

V. Phone/Fax

Practice location:
  • Phone: 662-778-2002
  • Fax:
Mailing address:
  • Phone: 662-778-2002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4353-23
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: