Individual
DR. MARLON DEAN WAKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
408 BERTUCCI BLVD, BILOXI, MS 39531-2339
(228) 388-5954
(228) 388-5922
Mailing address
408 BERTUCCI BLVD., BILOXI, MS 39531
(228) 388-5954
(228) 388-5922
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR 260 94
MS
Other
Enumeration date
04/27/2007
Last updated
07/08/2007
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