Provider Demographics
NPI:1699211516
Name:S&P VENTURES LLC
Entity Type:Organization
Organization Name:S&P VENTURES LLC
Other - Org Name:EAST RANKIN FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:
Authorized Official - Last Name:PLEASANT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-672-6371
Mailing Address - Street 1:410 LAURAL CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7095
Mailing Address - Country:US
Mailing Address - Phone:601-672-6371
Mailing Address - Fax:
Practice Address - Street 1:501 SECOND ST
Practice Address - Street 2:
Practice Address - City:PELAHATCHIE
Practice Address - State:MS
Practice Address - Zip Code:39145-2786
Practice Address - Country:US
Practice Address - Phone:601-854-7478
Practice Address - Fax:601-854-7437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3654-121223G0001X
MS3660-121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty