| NPI | 1396022497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DODD BRISTER Orthodontist 601-824-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS OR22292) |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |