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Individual

DR. HELEN V FAZYLOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
15816 LEMOYNE BLVD, SUITE A, BILOXI, MS 39532-4019
(228) 207-0046
(228) 207-0047
Mailing address
15816 LEMOYNE BLVD STE A, BILOXI, MS 39532-4048
(228) 207-0046
(228) 207-0047

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412901
VA
1223G0001X
General Practice Dentistry
Primary
3576-10
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08284523
MS
Enumeration date
07/06/2009
Last updated
07/08/2021
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