Individual
DR. DAVID RAY LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7732 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-0777
(662) 349-0782
Mailing address
7732 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-0777
(662) 349-0782
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1154-64
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS1639
TN
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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