Organization
DONALD G. TRAXLER, D.M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD G TRAXLER D.M.D. (PRESIDENT)
(601) 776-6630
Entity
Organization
Contact information
Practice address
303A S ARCHUSA AVE, QUITMAN, MS 39355-2325
(601) 776-6630
(601) 776-3825
Mailing address
303A S ARCHUSA AVE, P. O. BOX 159, QUITMAN, MS 39355-2325
(601) 776-6630
(601) 776-3825
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
185679
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660382
—
MS
Enumeration date
12/18/2006
Last updated
04/13/2017
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