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General NPI Number Information
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NPI Number | 1821592734
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Entity Type | Organization
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Legal Business Name | INTEGRITY DENTAL CLINIC, PLLC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 201 E LAYFAIR DR STE 100
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City | FLOWOOD
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State | MS
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Zip | 39232-7604
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Country | US
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Telephone | 601-487-2312
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Fax | 601-487-2555
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Provider Business Mailing Address
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Address Line | 201 E LAYFAIR DR STE 100
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City | FLOWOOD
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State | MS
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Zip | 39232-7604
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Country | US
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Telephone | 601-487-2312
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Fax | 601-487-2555
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS G RUMMELLS JR.
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Credential | DMD
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Telephone | 601-487-2312
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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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