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General NPI Number Information
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NPI Number | 1790144210
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Entity Type | Organization
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Legal Business Name | R&B DENTAL GROUP INC
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 152 HIGHWAY 15 N
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City | PONTOTOC
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State | MS
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Zip | 38863-1913
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Country | US
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Telephone | 662-534-4397
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Fax |
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Provider Business Mailing Address
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Address Line | 717 COULTER DR
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City | NEW ALBANY
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State | MS
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Zip | 38652-2808
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Country | US
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Telephone |
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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. DAVID KEVIN ROWAN
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Credential | DMD
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Telephone | 662-534-4397
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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 | 3737-14
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2885-95
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License Number State | MS
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