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Organization

DR VICTOR L WALSH DMD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VICTOR L WALSH D.M.D (OWNER/DOCTOR)
(601) 684-7921
Entity
Organization

Contact information

Practice address
1313 ASTON AVE, MCCOMB, MS 39648-2825
(601) 684-7921
(601) 684-7950
Mailing address
1313 ASTON AVE, MCCOMB, MS 39648-2825
(601) 684-7921
(601) 684-7950

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1619-74
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00063300
MS
Enumeration date
02/11/2011
Last updated
02/11/2011
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