Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 3732-14 | MS |
N | 1223G0001X | General Practice | 3732-14 | MS |
N | 213EG0000X | General Practice | 3732-14 | MS |
NPI | 1003103342 |
---|---|
Provider Name | Dr. Candice Brittany April |
First Address | Canton, MS 39046-0011 |
Second Address | Jackson, MS 39216-4500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 26/02/2018 |