Organization
DELTA ORTHODONTIC SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD V BROWN III DDS (OWNER/DENTIST)
(601) 636-3388
Entity
Organization
Contact information
Practice address
2356 GROVE STREET, VICKSBURG, MS 39183-2857
(601) 638-8230
(601) 636-3388
Mailing address
2356 GROVE STREET, VICKSBURG, MS 39183-2857
(601) 638-8230
(601) 636-3388
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
01/25/2022
Last updated
10/28/2022
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