Individual
WILLIAM HENRY VANN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.A.E.D.
Contact information
Practice address
7935 U.S. HWY 11, LUMBERTON, MS 39455
(601) 796-8449
(601) 796-9225
Mailing address
P.O. BOX 431, LUMBERTON, MS 39455
(601) 796-8449
(601) 796-9225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1736-76
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064465
—
MS
Enumeration date
01/27/2009
Last updated
01/27/2009
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