MEDICARE: DONALD E PRICE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	1766-77	MS

General Provider Information

NPI Number	:	1811075245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD E PRICE D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 789
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666-0789
Country	:	US
Telephone Number	:	601-276-7915
Fax Number	:	601-276-7929

Provider Business Practice Location Address
First Line	:	103 LAUREL STREET
Second Line	:
City	:	SUMMIT
State	:	MS
Zip	:	39666
Country	:	US
Telephone Number	:	601-276-7915
Fax Number	:	601-276-7929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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Directions to “ DONALD E PRICE D.D.S.” Practice Location

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