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General NPI Number Information
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NPI Number | 1952918278
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Entity Type | Organization
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Legal Business Name | LINCOLN DENTAL ARTS, PLLC
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 10/22/2020
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Provider Practice Location Address
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Address Line | 4301 LINCOLN RD # 20
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City | HATTIESBURG
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State | MS
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Zip | 39402-3036
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Country | US
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Telephone | 601-255-2599
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 416
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City | SALTILLO
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State | MS
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Zip | 38866-0416
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Country | US
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Telephone | 601-255-2599
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRETT HILDENBRAND
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Credential | DMD
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Telephone | 662-321-5883
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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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