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General NPI Number Information
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NPI Number | 1336279744
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Entity Type | Organization
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Legal Business Name | CHARLES E. ATKINS, JR. DMD
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 516 LINCOLN RD # A
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City | COLUMBUS
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State | MS
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Zip | 39705-2226
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Country | US
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Telephone | 662-329-3931
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Fax | 662-329-2509
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Provider Business Mailing Address
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Address Line | 137 PLANTATION DR
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City | COLUMBUS
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State | MS
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Zip | 39705-1138
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Country | US
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Telephone | 662-329-3931
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TORI MORDECAI
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Credential |
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Telephone | 662-329-3931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1284-07
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License Number State | MS
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