Organization
DELTA ORTHODONTIC SPECIALISTS, LLC
Active
Other names
Delta Orthodontic Specialists, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE GARDNER (OFFICE MANAGER)
(601) 638-8230
Entity
Organization
Contact information
Practice address
2356 GROVE ST, VICKSBURG, MS 39183-2857
(601) 638-8230
Mailing address
2356 GROVE ST, VICKSBURG, MS 39183-2857
(601) 638-8230
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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