Organization
SOUTHERN ORTHODONTIC SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R LIBBY DDS, MS (ORTHODONTIST)
(662) 349-0777
Entity
Organization
Contact information
Practice address
7732 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-0777
(662) 349-0782
Mailing address
7732 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5306
(662) 349-0777
(662) 349-0782
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1154-64
MS
Other
Enumeration date
02/22/2007
Last updated
08/22/2020
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