Umfress, Clastie Dean
Umfress, Clastie Dean is an individual health care provider with primary practice located at 579 E Goodman Road Suite #6 , Southaven MS 38671-9433. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Umfress, Clastie Dean can be contacted via phone (662) 536-2900.Contact Information
Primary practice address
579 E Goodman Road Suite #6
Southaven MS 38671-9433
Phone: (662) 536-2900
Fax: (662) 536-2990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3244-02 | Mississippi |
| Dental Providers / General Practice | 1223G0001X | 324402 | Mississippi |
Profile Details
| NPI number | 1790857738 |
|---|---|
| LBN Legal business name | Umfress, Clastie Dean |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Jan 11th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790857738 | NPPES |
| Mississippi | MEDICAID | 173192192 | |
| Mississippi | MEDICAID | DNT173192192 |
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