Individual
CHARLES FREDERICK EZELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2655 LAKELAND DR, FLOWOOD, MS 39232-9516
(601) 932-8212
(601) 939-8169
Mailing address
2655 LAKELAND DR, FLOWOOD, MS 39232-9516
(601) 932-8212
(601) 939-8169
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1924-81
MS
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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