| South Mississippi Oral Surgery & Implant Center Pllc | |
|
12231 Bernard Pkwy Gulfport MS 39503-5086 | |
| (601) 264-7611 | |
| (601) 268-0693 |
| Full Name | South Mississippi Oral Surgery & Implant Center Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 12231 Bernard Pkwy, Gulfport, Mississippi |
| Authorized Official Name and Position | Bennett Van York (OWNER) |
| Authorized Official Contact | 6012647611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Mississippi Oral Surgery & Implant Center Pllc 1421 S 28th Ave Hattiesburg MS 39402-3108 Ph: (601) 264-7611 | South Mississippi Oral Surgery & Implant Center Pllc 12231 Bernard Pkwy Gulfport MS 39503-5086 Ph: (601) 264-7611 |
| NPI Number | 1780466300 |
|---|---|
| Provider Enumeration Date | 10/18/2023 |
| Last Update Date | 10/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780466300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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