Moses Oral And Facial Surgery Llc | |
202 W Park Ave Greenwood MS 38930-3009 | |
(662) 219-0044 | |
Not Available |
Full Name | Moses Oral And Facial Surgery Llc |
---|---|
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 202 W Park Ave, Greenwood, Mississippi |
Authorized Official Name and Position | Walter Carl Moses (DOCTOR) |
Authorized Official Contact | 6622990270 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Moses Oral And Facial Surgery Llc 202 W Park Ave Greenwood MS 38930-3009 Ph: (662) 219-0044 | Moses Oral And Facial Surgery Llc 202 W Park Ave Greenwood MS 38930-3009 Ph: (662) 219-0044 |
NPI Number | 1609407907 |
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Provider Enumeration Date | 01/27/2020 |
Last Update Date | 01/27/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609407907 | NPI | - | NPPES |
07720764 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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