Provider Demographics
NPI:1295937498
Name:DR. LOUIS B. GUY, JR.,DDS, MSPA
Entity type:Organization
Organization Name:DR. LOUIS B. GUY, JR.,DDS, MSPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:GUY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:601-981-5004
Mailing Address - Street 1:4500 INTERSTATE 55
Mailing Address - Street 2:247 HIGHLAND VILLAGE
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211
Mailing Address - Country:US
Mailing Address - Phone:601-981-5004
Mailing Address - Fax:
Practice Address - Street 1:247 HIGHLAND VILLAGE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211
Practice Address - Country:US
Practice Address - Phone:601-981-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1349-691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty