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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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