| Lloyd B. Wolfe, Jr., D.m.d. | |
| 
					92 Hal Crocker Rd Ellisville MS 39437-2089  | |
| (601) 261-0105 | |
| (601) 800-8064 | 
| Full Name | Lloyd B. Wolfe, Jr., D.m.d. | 
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics | 
| Location | 92 Hal Crocker Rd, Ellisville, Mississippi | 
| Authorized Official Name and Position | Lloyd B Wolfe (ORTHODONTIST) | 
| Authorized Official Contact | 6012610105 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lloyd B. Wolfe, Jr., D.m.d. 92 Hal Crocker Rd Ellisville MS 39437-2089 Ph: (601) 261-0105  | Lloyd B. Wolfe, Jr., D.m.d. 92 Hal Crocker Rd Ellisville MS 39437-2089 Ph: (601) 261-0105  | 
| NPI Number | 1154533834 | 
|---|---|
| Provider Enumeration Date | 05/04/2007 | 
| Last Update Date | 06/04/2013 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1154533834 | NPI | - | NPPES | 
| 05875831 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 210884 (Mississippi) | Primary | 
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