Individual
PAUL DEVON GUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
101 RIDGEWOOD CIR, KOSCIUSKO, MS 39090-3265
(662) 289-7076
(662) 289-7050
Mailing address
101 RIDGEWOOD CIR, KOSCIUSKO, MS 39090-3265
(662) 289-7076
(662) 289-7050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3415-07
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014559
—
MS
Enumeration date
06/14/2007
Last updated
09/27/2012
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