Individual
DR. GERALD W. SEGRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15382 SAINT CHARLES ST # A, GULFPORT, MS 39503-3122
(228) 832-5300
(228) 832-7626
Mailing address
15382 SAINT CHARLES ST # A, GULFPORT, MS 39503-3122
(228) 832-5300
(228) 832-7626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1616-74
MS
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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