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General NPI Number Information
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NPI Number | 1861245946
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Entity Type | Organization
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Legal Business Name | KRINGLE DENTISTRY PLLC
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Dates
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Enumeration Date | 04/09/2024
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 1526 SUNSET DR
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City | GRENADA
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State | MS
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Zip | 38901-4507
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Country | US
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Telephone | 662-614-1273
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Fax |
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Provider Business Mailing Address
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Address Line | 1196 MORRISON DR
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City | GRENADA
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State | MS
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Zip | 38901-5518
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Country | US
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Telephone | 662-614-1273
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | KASEY KRINGLE
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Credential | DMD
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Telephone | 662-614-1273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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