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

Back Bay Family Dentistry

Organization General Practice Dentistry · NPI 1316306988

Back Bay Family Dentistry is a General Practice Dentistry in Diberville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2016.

Licensed in
MS
In the registry since
2016

Practice location Address checks out

10409 Boney Ave
Diberville, MS 39540-4813
Phone: (228) 392-0509
Fax: (228) 392-8709
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3553-10 (MS)

Record details

NPI number1316306988
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeremy Parker — Owner · (228) 392-0509
NPI enumeratedFebruary 11, 2016
Last updated in NPPESFebruary 11, 2016
Mailing address10409 Boney Ave, Diberville, MS 39540-4813

Other providers in Diberville