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General NPI Number Information
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NPI Number | 1487877221
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Entity Type | Individual
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Provider Name | HARVEY MILES SHIRLEY DMD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2400 16TH ST
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City | MERIDIAN
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State | MS
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Zip | 39301-3955
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Country | US
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Telephone | 601-483-6021
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Fax | 601-483-1140
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Provider Business Mailing Address
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Address Line | 4509 9TH AVE
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City | MERIDIAN
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State | MS
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Zip | 39305-2815
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Country | US
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Telephone | 601-483-4946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3104-99
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License Number State | MS
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