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1225048911
MARIO E ALFONSO
SOUTHAVEN, MS
NPI
1225048911
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist General Practice
(Licence: MS MS2062-84)
Enumeration Date
2006-08-08
Last Update Date
2007-07-08
Business Address
DR. MARIO E ALFONSO D.D.S.
7085 SWINNEA RD SUITE A
SOUTHAVEN, MS 38671-6001
Phone number: 662-349-3038
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Mailing Address
DR. MARIO E ALFONSO D.D.S.
7085 SWINNEA RD SUITE A
SOUTHAVEN, MS 38671-6001
Phone number: 662-349-3038
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