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1639318116
ROGER STEPHENSON WIRTZ
JACKSON, MS
NPI
1639318116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MS 2040-83)
Enumeration Date
2009-02-06
Last Update Date
2009-02-06
Business Address
Dr. ROGER STEPHENSON WIRTZ D.M.D.
1765 LELIA DR.
JACKSON, MS 39216-4820
Phone number: 601-982-5349
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Mailing Address
Dr. ROGER STEPHENSON WIRTZ D.M.D.
1765 LELIA DRIVE
JACKSON, MS 39216-4820
Phone number: 601-982-5349
Copy
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