Individual
DR. SUZANNA ELLZEY NIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4348 LINCOLN RD., HATTIESBURG, MS 39402
(601) 261-5552
Mailing address
10 AVERY KNOLL, HATTIESBURG, MS 39402
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3794-15
MS
Other
Enumeration date
06/04/2015
Last updated
10/02/2018
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