Organization
DORMOIS & FUSON, P.L.L.C.
Active
Other names
PEDIATRIC DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ORFANS C.D.A. (OFFC MGR)
(662) 349-3838
Entity
Organization
Contact information
Practice address
7734 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-3838
(662) 349-5923
Mailing address
7734 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-3838
(662) 349-5923
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/29/2006
Last updated
02/23/2012
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