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Organization

MOSES ORAL AND FACIAL SURGERY LLC

Active
Other names
Moses Oral and Facial Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER CARL MOSES III DMD (DOCTOR)
(662) 299-0270
Entity
Organization

Contact information

Practice address
202 W PARK AVE, GREENWOOD, MS 38930-3009
(662) 219-0044
Mailing address
202 W PARK AVE, GREENWOOD, MS 38930-3009
(662) 219-0044

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07720764
MS
Enumeration date
01/27/2020
Last updated
01/27/2020
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