Roderick L. Coleman, D.M.D., Pa in Vicksburg - Pediatric Dentistry
Roderick L. Coleman, D.M.D., Pa - NPI 1962686394
Roderick L. Coleman, D.M.D., Pa is a Pediatric Dentistry in Vicksburg, Mississippi. Roderick L. Coleman, D.M.D., Pa practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Roderick L. Coleman, D.M.D., Pa is 1962686394. The last update date is 2007-12-20.
Roderick L. Coleman, D.M.D., Pa's current location address is 120 Holt Collier Dr, Vicksburg, Mississippi. You can contact this provider via phone number 6016194777 and fax number 6016194667. The mailing address for Roderick L. Coleman, D.M.D., Pa is 120 Holt Collier Dr, Vicksburg, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Roderick L. Coleman, D.M.D., Pa |
|---|---|
| Address | 120 Holt Collier Dr, Vicksburg, Mississippi |
| Phone Number | 6016194777 |
| Fax Number | 6016194667 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Coleman L Roderick |
| Credentials | D.M.D. |
| Telephone Number | 6016194777 |
NPI Number Detail
| NPI Number | 1962686394 |
|---|---|
| Provider Enumeration Date | 2007-12-20 |
| Last Updated Date | 2007-12-20 |
Provider Mailing Address Detail
| Address | 120 Holt Collier Dr |
|---|---|
| City | Vicksburg |
| State | Mississippi (MS) |
| Post Code | 391834408 |
| Phone Number | 6016194777 |
| Fax Number | 6016194667 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 315300 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2988820 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Roderick L. Coleman, D.M.D., Pa by the Centers for Medicare & Medicaid Services?
The Roderick L. Coleman, D.M.D., Pa has been assigned the NPI (National Provider Identifier) 1962686394 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Roderick L. Coleman, D.M.D., Pa is physically located?
The Roderick L. Coleman, D.M.D., Pa is physically situated at the following address: 120 Holt Collier Dr, Vicksburg, MS, 391834408.
What is Roderick L. Coleman, D.M.D., Pa's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Roderick L. Coleman, D.M.D., Pa is Pediatric Dentistry, and the taxonomy code that categorizes this field of expertise is 1223P0221X.
When did Roderick L. Coleman, D.M.D., Pa receive its 1962686394 assignment?
The Roderick L. Coleman, D.M.D., Pa was assigned its 1962686394 on 2007-12-20, which is the date when this unique identifier was issued to the organization.
As of what date were the Roderick L. Coleman, D.M.D., Pa's details last updated?
The information pertaining to the Roderick L. Coleman, D.M.D., Pa, including its address, specialty, and other details, was most recently updated on 2007-12-20.