Leslie Anne Carty, DMD

Individual provider Active NPI General Practice Dentistry · Wesson, MS

NPI 1306047972 · NPPES record last updated Apr 23, 2008

Key facts

NPI
1306047972
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
3123-00 (MS)
Practice address
2076 Highway 51 NE
Wesson, MS 39191-6859
Phone
(601) 643-0026
Fax
(601) 643-0530
NPI assigned
May 30, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3123-00MSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3123-00 MS Yes

Addresses

Primary practice location

2076 Highway 51 NE
Wesson, MS 39191-6859

Mailing address

PO Box 69
2076 Hwy. 51 North
Wesson, MS 39191-0069
Phone (601) 643-0026

Other identifiers

IdentifierTypeStateIssuer
00660375MedicaidMS
551182OtherMSUNITED CONCORDIA

Other providers in Wesson, MS

All providers in Wesson, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.