Individual
DR. GORDON EARL FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1904 HARDY ST, HATTIESBURG, MS 39401-4983
(601) 583-2250
(601) 583-2272
Mailing address
3737 S CLAIBORNE AVE, NEW ORLEANS, LA 70125-4603
(504) 289-4602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3268-03
MS
1223G0001X
General Practice Dentistry
Primary
3515
LA
1223P0221X
Pediatric Dentistry
PEDO3703
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1835153
—
LA
Enumeration date
07/19/2006
Last updated
07/16/2013
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