Gulf Islands Dentistry, Pllc | |
1226 Jackson Ave Pascagoula MS 39567-4348 | |
(228) 769-9010 | |
(228) 762-0303 |
Full Name | Gulf Islands Dentistry, Pllc |
---|---|
Speciality | Dentist |
Location | 1226 Jackson Ave, Pascagoula, Mississippi |
Authorized Official Name and Position | Russell Parker (PRESIDENT) |
Authorized Official Contact | 2287699010 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gulf Islands Dentistry, Pllc 1226 Jackson Ave Pascagoula MS 39567-4348 Ph: (228) 769-9010 | Gulf Islands Dentistry, Pllc 1226 Jackson Ave Pascagoula MS 39567-4348 Ph: (228) 769-9010 |
NPI Number | 1831576644 |
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Provider Enumeration Date | 04/30/2015 |
Last Update Date | 04/30/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831576644 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 333605 (Mississippi) | Primary |
122300000X | Dentist | 375014 (Mississippi) | Secondary |
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