Organization
HATTIESBURG ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY FALER STANLEY D.M.D. M.S. (OWNER)
(601) 450-2141
Entity
Organization
Contact information
Practice address
704 S 28TH AVE, SUITE 20, HATTIESBURG, MS 39402-2524
(601) 450-2141
Mailing address
704 S 28TH AVE, SUITE 20, HATTIESBURG, MS 39402-2524
(601) 450-2141
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3110-99
MS
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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