OrganizationActive
Grenada Dental Clinic PLLC
NPI 1851886857 · Dental Clinic/Center · Grenada, MS
Provider details
- NPI number
- 1851886857
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Olivia Van Gordon, Dentist(662) 226-1757
- License
- 3934-17 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1800 Hill Dr Ste a
Grenada, MS 38901-5071
Phone: (662) 226-1757
Fax: (662) 307-2709
Approximate (ZIP-level) locationGet directions
Mailing address
1800 Hill Dr Ste a
Grenada, MS 38901-5071
Registry dates
- Enumerated
- 2018-06-22
- Last updated
- 2018-06-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.