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General NPI Number Information
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NPI Number | 1568188258
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Entity Type | Organization
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Legal Business Name | LAMAR DENTAL PLLC
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 6414 U S HIGHWAY 98 STE 10
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City | HATTIESBURG
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State | MS
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Zip | 39402-7838
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Country | US
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Telephone | 601-543-3745
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Fax |
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Provider Business Mailing Address
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Address Line | 6414 U S HIGHWAY 98 STE 10
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City | HATTIESBURG
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State | MS
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Zip | 39402-7838
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Country | US
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Telephone | 601-543-3745
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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. LEAH WAITS
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Credential | D.M.D
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Telephone | 601-543-3745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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