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

Tillery Dental Clinics, PA

Organization General Practice Dentistry · NPI 1376656041

Tillery Dental Clinics, PA provides General Practice Dentistry in Laurel, Mississippi. Licensed in Mississippi. Registered with an NPI since 2006.

Licensed in
MS
In the registry since
2006
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

1508 W 10th St
Laurel, MS 39440-2668 Not confirmed with CMS for 18 years — call before visiting
Phone: (601) 428-6093
Fax: (601) 428-6096
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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 MS133268 (MS)

Record details

NPI number1376656041
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Tillery — Owner · (601) 428-6093
NPI enumeratedAugust 16, 2006
Last updated in NPPESJanuary 3, 2008
Mailing address1508 W 10th St, Laurel, MS 39440-2668

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