Olive Branch Orthodontics | |
785 Ohio Ave Ste 3h Clarksdale MS 38614-6215 | |
(662) 627-9001 | |
(662) 627-3662 |
Full Name | Olive Branch Orthodontics |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 785 Ohio Ave Ste 3h, Clarksdale, Mississippi |
Authorized Official Name and Position | Ivan Bryant Hirsberg (ORTHODONTIST) |
Authorized Official Contact | 6626279001 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Olive Branch Orthodontics 785 Ohio Ave Ste 3h Clarksdale MS 38614-6215 Ph: (662) 627-9001 | Olive Branch Orthodontics 785 Ohio Ave Ste 3h Clarksdale MS 38614-6215 Ph: (662) 627-9001 |
NPI Number | 1003113879 |
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Provider Enumeration Date | 02/14/2011 |
Last Update Date | 02/14/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003113879 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3042-98 (Mississippi) | Primary |
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Austin Poole, Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 705 S Choctaw St, Clarksdale, MS 38614 Phone: 662-627-7324 Fax: 662-627-7325 | |
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