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General NPI Number Information
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NPI Number | 1326763558
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Entity Type | Organization
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Legal Business Name | ANNA JENNINGS NIX, DMD, PLLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 539 HIGHWAY 80 W STE A
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City | CLINTON
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State | MS
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Zip | 39056-4156
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Country | US
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Telephone | 601-924-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 315 PENROSE PL
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City | MADISON
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State | MS
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Zip | 39110-1200
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Country | US
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Telephone | 662-299-5530
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNA JENNINGS NIX
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Credential | DMD
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Telephone | 601-924-4900
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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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