Individual
DR. JEFFERSON RIDGWAY GAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
240 CALDWELL DR, HAZLEHURST, MS 39083-2723
(601) 894-4732
(601) 894-4732
Mailing address
421 KINGSBRIDGE RD, MADISON, MS 39110-7644
(601) 506-1642
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3536-10
MS
Other
Enumeration date
06/04/2010
Last updated
07/28/2010
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