Provider Demographics
NPI:1598282162
Name:RMW DMD, PA
Entity Type:Organization
Organization Name:RMW DMD, PA
Other - Org Name:SOUTHERN MAGNOLIA SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-215-1202
Mailing Address - Street 1:6819 WASHINGTON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2181
Mailing Address - Country:US
Mailing Address - Phone:228-215-1202
Mailing Address - Fax:228-447-4775
Practice Address - Street 1:6819 WASHINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2181
Practice Address - Country:US
Practice Address - Phone:228-215-1202
Practice Address - Fax:228-447-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3600-111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty