Individual
EDWARD L ENGEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D., M.S.
Contact information
Practice address
843 S MAIN ST, GREENVILLE, MS 38701-5871
(662) 378-8645
(662) 332-9434
Mailing address
843 S MAIN ST, GREENVILLE, MS 38701-5871
(662) 378-8645
(662) 332-9434
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
171276
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR677
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00005858
—
MS
Enumeration date
03/17/2008
Last updated
03/17/2008
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