Organization
EAST MISSISSIPPI ORAL & FACIAL SURGERY, LLC
Active
Organization
EAST MISSISSIPPI ORAL & FACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASIF A LALA DMD, MD (OWNER)
(912) 675-8468
Entity
Organization
Contact information
Practice address
1212 24TH AVENUE, MERIDIAN, MS 39301
(601) 286-5240
Mailing address
1212 24TH AVENUE, MERIDIAN, MS 39301
(601) 286-5240
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
3785-15
MS
Other
Enumeration date
09/18/2015
Last updated
03/18/2016
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