Provider Demographics
NPI:1750450581
Name:PRESLEY, JAMES ANTHONY (DMD,FAGD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:PRESLEY
Suffix:
Gender:M
Credentials:DMD,FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W HARPER ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MS
Mailing Address - Zip Code:39218-4406
Mailing Address - Country:US
Mailing Address - Phone:601-932-5100
Mailing Address - Fax:601-939-3080
Practice Address - Street 1:125 W HARPER ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-4406
Practice Address - Country:US
Practice Address - Phone:601-932-5100
Practice Address - Fax:601-939-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1990821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice