Individual
DR. ROGER E PRADELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-0512
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-0512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0001101
DE
Other
Enumeration date
08/17/2005
Last updated
04/26/2018
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