Provider Demographics
NPI:1760150833
Name:DOWNS FAMILY DENTISTRY
Entity Type:Organization
Organization Name:DOWNS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:662-728-1999
Mailing Address - Street 1:400 S SECOND ST
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-4311
Mailing Address - Country:US
Mailing Address - Phone:662-728-1999
Mailing Address - Fax:
Practice Address - Street 1:400 S SECOND ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-4311
Practice Address - Country:US
Practice Address - Phone:662-728-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental