Individual
DR. KINYATTA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
13179 THREE RIVERS RD, GULFPORT, MS 39503-4944
(228) 832-1000
Mailing address
13179 THREE RIVERS RD, GULFPORT, MS 39503-4944
(228) 832-1000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
356410
MS
Other
Enumeration date
02/02/2011
Last updated
11/12/2015
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