| Moses Oral And Facial Surgery Llc | |
|
202 W Park Ave Greenwood MS 38930-3009 | |
| (662) 219-0044 | |
| Not Available |
| Full Name | Moses Oral And Facial Surgery Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 202 W Park Ave, Greenwood, Mississippi |
| Authorized Official Name and Position | Walter Carl Moses (DOCTOR) |
| Authorized Official Contact | 6622990270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moses Oral And Facial Surgery Llc 202 W Park Ave Greenwood MS 38930-3009 Ph: (662) 219-0044 | Moses Oral And Facial Surgery Llc 202 W Park Ave Greenwood MS 38930-3009 Ph: (662) 219-0044 |
| NPI Number | 1609407907 |
|---|---|
| Provider Enumeration Date | 01/27/2020 |
| Last Update Date | 01/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609407907 | NPI | - | NPPES |
| 07720764 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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