Provider Demographics
NPI:1427145622
Name:NORTH MISSISSIPPI ORTHODONTIC ASSOCIATES PA
Entity type:Organization
Organization Name:NORTH MISSISSIPPI ORTHODONTIC ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:662-842-1735
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38802-0526
Mailing Address - Country:US
Mailing Address - Phone:662-842-1735
Mailing Address - Fax:662-842-1769
Practice Address - Street 1:99 PARKGATE DRIVE
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-3006
Practice Address - Country:US
Practice Address - Phone:662-842-1735
Practice Address - Fax:662-842-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty