Provider Demographics
NPI:1851979868
Name:IUKA FAMILY DENTAL, PLLC
Entity Type:Organization
Organization Name:IUKA FAMILY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-287-3156
Mailing Address - Street 1:1025 FOOTE ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-4911
Mailing Address - Country:US
Mailing Address - Phone:662-287-3156
Mailing Address - Fax:662-287-3157
Practice Address - Street 1:915 BATTLEGROUND DR
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-1320
Practice Address - Country:US
Practice Address - Phone:662-424-0307
Practice Address - Fax:662-660-7145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTAL ARTS OF CORINTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental