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Individual

DR. LOUIE V HARRISON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
412 TYLER HOLMES DR, WINONA, MS 38967-1522
(662) 283-4722
(662) 283-2588
Mailing address
412 TYLER HOLMES DR, WINONA, MS 38967-1522
(662) 283-4722
(662) 283-2588

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2278-86
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0060241
MS
01
2278-86
DENTAL LICENSE #
MS
Enumeration date
02/25/2008
Last updated
02/25/2008
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