| Ellisville Family Dental Center Pa | |
|
401 Highway 11 S Ellisville MS 39437-3103 | |
| (601) 477-3771 | |
| Not Available |
| Full Name | Ellisville Family Dental Center Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 401 Highway 11 S, Ellisville, Mississippi |
| Authorized Official Name and Position | Stephen L Surber (OWNER) |
| Authorized Official Contact | 6014773771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellisville Family Dental Center Pa 401 Highway 11 S Ellisville MS 39437-3103 Ph: (601) 477-3771 | Ellisville Family Dental Center Pa 401 Highway 11 S Ellisville MS 39437-3103 Ph: (601) 477-3771 |
| NPI Number | 1033269840 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 08/31/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033269840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2366-87 (Mississippi) | Primary |
Ellisville State School Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Highway 11 S, Ellisville, MS 39437 Phone: 601-477-9384 Fax: 601-477-5700 | |
Lloyd B. Wolfe, Jr., D.m.d. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 92 Hal Crocker Rd, Ellisville, MS 39437 Phone: 601-261-0105 Fax: 601-800-8064 | |
Dental Group Of Ellisville, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 97 Hal Crocker Road, Ellisville, MS 39437 Phone: 601-477-3779 Fax: 601-477-3770 |