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General NPI Number Information
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NPI Number | 1215804588
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Entity Type | Organization
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Legal Business Name | NORTHEAST MISSISSIPPI PEDIATRIC DENTAL ASSOCIATES, LLC.
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 1500 N HARPER RD STE 5
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City | CORINTH
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State | MS
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Zip | 38834-3700
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Country | US
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Telephone | 662-513-4188
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N HARPER RD STE 5
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City | CORINTH
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State | MS
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Zip | 38834-3700
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Country | US
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Telephone | 662-513-4188
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. C.HAYDEN PERKINS
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Credential |
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Telephone | 662-513-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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