Organization
LLOYD B. WOLFE, JR., D.M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LLOYD B. WOLFE JR. D.M.D. (ORTHODONTIST)
(601) 957-9200
Entity
Organization
Contact information
Practice address
406 BRIARWOOD DR STE 102, JACKSON, MS 39206-3059
(601) 957-9200
(601) 957-2060
Mailing address
406 BRIARWOOD DR STE 102, JACKSON, MS 39206-3059
(601) 957-9200
(601) 957-2060
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
210884
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01589571
—
MS
Enumeration date
05/01/2007
Last updated
06/05/2013
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