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Individual

JIMMY F VESSELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1011 MISSION 66, VICKSBURG, MS 39183-2753
(601) 636-6081
(601) 638-5482
Mailing address
1011 MISSION 66, VICKSBURG, MS 39183-2753
(601) 636-6081
(601) 638-5482

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
930-59
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00064667
MS
01
226519
TRIGON
MS
01
517629
UNITED CONCORDIA
MS
01
930
DELTA DENTAL
MS
Enumeration date
03/28/2006
Last updated
07/08/2007
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