Provider Demographics
NPI:1427145044
Name:THE DENTAL SOLUTION
Entity type:Organization
Organization Name:THE DENTAL SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-925-5163
Mailing Address - Street 1:315 MORRISON DRIVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:89056
Mailing Address - Country:US
Mailing Address - Phone:601-925-5163
Mailing Address - Fax:601-925-5184
Practice Address - Street 1:315 MORRISON DRIVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:89056
Practice Address - Country:US
Practice Address - Phone:601-925-5163
Practice Address - Fax:601-925-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2559901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty