Provider Demographics
NPI:1740458140
Name:HELTON FAMILY DENTAL CARE PA
Entity type:Organization
Organization Name:HELTON FAMILY DENTAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-257-9700
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-0456
Mailing Address - Country:US
Mailing Address - Phone:662-257-9700
Mailing Address - Fax:662-257-9730
Practice Address - Street 1:1202 GUY PICKLE DRIVE
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-8212
Practice Address - Country:US
Practice Address - Phone:662-257-9700
Practice Address - Fax:662-257-9730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty