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General NPI Number Information
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NPI Number | 1467011379
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Entity Type | Organization
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Legal Business Name | WEST POINT FAMILY DENTAL PLLC
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Dates
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Enumeration Date | 06/13/2019
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 26652 E MAIN ST
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City | WEST POINT
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State | MS
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Zip | 39773-7544
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Country | US
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Telephone | 662-494-1869
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Fax | 662-494-7883
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Provider Business Mailing Address
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Address Line | 3823 HIGHWAY 80 E STE 400
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City | PEARL
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State | MS
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Zip | 39208-4275
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Country | US
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Telephone | 601-664-9300
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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. ROBERT HAYES
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Credential | DMD
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Telephone | 601-720-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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