| NPI | 1649586520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERSON R GAMBLIN Member 601-894-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MS OR 431-10) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |