Provider Demographics
NPI:1578759916
Name:MERIDIAN CENTER FOR ORAL AND FACIAL SURGERY,PLLC
Entity Type:Organization
Organization Name:MERIDIAN CENTER FOR ORAL AND FACIAL SURGERY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:601-484-6725
Mailing Address - Street 1:1703 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-3104
Mailing Address - Country:US
Mailing Address - Phone:601-484-6725
Mailing Address - Fax:601-484-5083
Practice Address - Street 1:1703 23RD AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-3104
Practice Address - Country:US
Practice Address - Phone:601-484-6725
Practice Address - Fax:601-484-5083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty