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DR. JEANNA LYN AULTMAN D.M.D.

>> Dentist >> Dental Providers

Registrant NPI Number: 1326486499

Individual Registrant:
DR. JEANNA LYN AULTMAN D.M.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
4556 HIGHWAY 589  SUMRALL, MS 39482-3979 US
Tel: 601-758-0150  Fax: 601-758-0149

Contact information for business:
PO BOX 469  SUMRALL, MS 39482 US
Tel: 601-758-0150  Fax: 601-758-0149

Registration Information:
NPI: 1326486499
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
MS3690-13

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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