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General NPI Number Information
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NPI Number | 1811254931
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Entity Type | Organization
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Legal Business Name | MERIDIAN COMMUNITY COLLEGE
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 910 HIGHWAY 19 NORTH
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City | MERIDIAN
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State | MS
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Zip | 39307
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Country | US
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Telephone | 601-484-8748
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Fax | 601-484-8743
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Provider Business Mailing Address
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Address Line | 910 HIGHWAY 19 NORTH
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City | MERIDIAN
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State | MS
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Zip | 39307
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Country | US
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Telephone | 601-484-8748
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Fax | 601-484-8743
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Authorized Official
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Title or Position | DIRECTOR OF DENTAL PROGRAMS
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Name | DR. WILLIAM GLENN LINDSAY
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Credential | D.D.S.
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Telephone | 601-484-8751
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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 | NO. 1983-82
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License Number State | MS
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