OrganizationActive
Decatur Dental, LLC
NPI 1073985925 · Dental Clinic/Center · Decatur, MS
Provider details
- NPI number
- 1073985925
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jim Polles, Owner(601) 362-1118
- License
- 3402-06 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
68 Fourth Ave
Decatur, MS 39327-9713
Phone: (601) 635-2340
Street-level locationGet directions
Mailing address
1836 Crane Ridge Dr
Jackson, MS 39216-4901
Registry dates
- Enumerated
- 2015-10-30
- Last updated
- 2015-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.