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General NPI Number Information
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NPI Number | 1093374167
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Entity Type | Organization
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Legal Business Name | LD-OXFORD, LLC
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 2608 S LAMAR BLVD
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City | OXFORD
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State | MS
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Zip | 38655-5243
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Country | US
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Telephone | 662-281-8455
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Fax | 815-461-8253
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Provider Business Mailing Address
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Address Line | 2608 S LAMAR BLVD
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City | OXFORD
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State | MS
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Zip | 38655-5243
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Country | US
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Telephone | 662-281-8455
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Fax | 815-461-8253
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | LAUREN S DAIGNEAULT
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Credential | BA, MA
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Telephone | 256-783-9468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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