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General NPI Number Information
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NPI Number | 1801531116
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Entity Type | Organization
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Legal Business Name | LEFLEUR DENTAL GROUP
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 1437 OLD SQUARE RD # STU105
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City | JACKSON
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State | MS
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Zip | 39211-5535
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Country | US
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Telephone | 601-956-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 4036 OAKRIDGE DR
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City | JACKSON
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State | MS
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Zip | 39216-3413
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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 | PRESIDENT
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Name | WILLIAM C. MAYFIELD
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Credential | DMD
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Telephone | 601-291-4127
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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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