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

Ellisville Family Dental Center PA

Organization General Practice Dentistry · NPI 1033269840

Ellisville Family Dental Center PA is a General Practice Dentistry in Ellisville, Mississippi. Licensed in Mississippi. Registered with an NPI since 2007.

Licensed in
MS
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

401 Highway 11 S
Ellisville, MS 39437-3103
Phone: (601) 477-3771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2366-87 (MS)

Record details

NPI number1033269840
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Surber — Owner · (601) 477-3771
NPI enumeratedJanuary 12, 2007
Last updated in NPPESAugust 31, 2016
Mailing address401 Highway 11 S, Ellisville, MS 39437-3103

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