Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

627 Main Tupelo Professional PLLC

Organization General Practice Dentistry · NPI 1255045019

627 Main Tupelo Professional PLLC is a General Practice Dentistry in Tupelo, Mississippi. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

627 W Main St
Tupelo, MS 38804-3732
Phone: (662) 840-0066
Fax: (662) 840-7966
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1255045019
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peter Grumbos — Owner · (662) 840-0066
Other names Main Street Family Dentistry
NPI enumeratedJanuary 6, 2023
Last updated in NPPESJanuary 6, 2023
Certification dateJanuary 6, 2023
Mailing address627 W Main St, Tupelo, MS 38804-3732

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