Organization
WGO DENTAL, LLC
Active
Other names
VIP Smiles Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLORA EVANS DMD (OWNER)
(601) 594-9202
Entity
Organization
Contact information
Practice address
5858 RIDGEWOOD RD, JACKSON, MS 39211-2617
(601) 594-9202
Mailing address
5858 RIDGEWOOD RD, JACKSON, MS 39211-2617
(601) 594-9202
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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