| 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 |
|---|---|
| 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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