NPI 1376656041

Tillery Dental Clinics, P.A.

Organisation General Practice Dentistry Laurel, MS

Practice location

Address: 1508 W 10th St, Laurel, MS 39440-2668
Phone: (601) 428-6093
Fax: (601) 428-6096

Authorised official

Name: Douglas W. Tillery
Title: Owner
Phone: (601) 428-6093

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence MS133268 (MS)

Other Dentist providers in Mississippi →

Registry record

NPI: 1376656041
Entity type: Organization
NPI issued: 16 Aug 2006
Record last updated: 3 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.