Individual
BARBARA DANIELA OLIVOS BAZAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6110
Mailing address
206 COMSTOCK LN, MADISON, MS 39110-8364
(769) 253-5500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
PVRTP11923
MS
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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