G. Dodd Brister, Jr., Dds, Pa | |
3007 Greenfield Rd Pearl MS 39208-8712 | |
(601) 824-5878 | |
Not Available |
Full Name | G. Dodd Brister, Jr., Dds, Pa |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 3007 Greenfield Rd, Pearl, Mississippi |
Authorized Official Name and Position | Gerald Dodd Brister (ORTHODONTIST) |
Authorized Official Contact | 6018245878 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
G. Dodd Brister, Jr., Dds, Pa 3007 Greenfield Rd Pearl MS 39208-8712 Ph: (601) 824-5878 | G. Dodd Brister, Jr., Dds, Pa 3007 Greenfield Rd Pearl MS 39208-8712 Ph: (601) 824-5878 |
NPI Number | 1396022497 |
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Provider Enumeration Date | 11/03/2011 |
Last Update Date | 11/03/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396022497 | NPI | - | NPPES |
00660332 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | OR22292 (Mississippi) | Primary |
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