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) 261-0105
Entity
Organization
Contact information
Practice address
92 HAL CROCKER RD, ELLISVILLE, MS 39437-2089
(601) 261-0105
(601) 800-8064
Mailing address
92 HAL CROCKER RD, ELLISVILLE, MS 39437-2089
(601) 261-0105
(601) 800-8064
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
—
05875831
—
MS
Enumeration date
05/04/2007
Last updated
06/04/2013
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