OrganizationActive
Canton Communitydentalclinicllc
NPI 1568567477 · General Practice Dentistry · Canton, MS
Provider details
- NPI number
- 1568567477
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Timothy Johnson, Dentist(601) 855-5885
- License
- 3108-99 (MS)
Specialties & taxonomies
Dental Providers
Practice location
512 W Fulton St
Canton, MS 39046-4254
Phone: (601) 855-5885
Fax: (601) 855-2833
Approximate (ZIP-level) locationGet directions
Mailing address
512 W Fulton St
Canton, MS 39046-4254
Registry dates
- Enumerated
- 2006-09-14
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.