| Pfd Llc | |
|
412 Security Sq Gulfport MS 39507-1952 | |
| (228) 896-6321 | |
| (228) 896-6322 |
| Full Name | Pfd Llc |
|---|---|
| Speciality | Dentist |
| Location | 412 Security Sq, Gulfport, Mississippi |
| Authorized Official Name and Position | Jason Papania (OWNER) |
| Authorized Official Contact | 2282346321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pfd Llc 412 Security Sq Gulfport MS 39507-1952 Ph: (228) 896-6321 | Pfd Llc 412 Security Sq Gulfport MS 39507-1952 Ph: (228) 896-6321 |
| NPI Number | 1558816181 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 11/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558816181 | NPI | - | NPPES |
| 04524749 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3305-04 (Mississippi) | Primary |
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