Individual
DR. JOSEPH N GARDNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1718 S MAIN ST, POPLARVILLE, MS 39470-4287
(601) 795-8024
Mailing address
136 HOWARD HEIGHTS RD, POPLARVILLE, MS 39470-7426
(601) 795-2769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1714-76
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064315
—
MS
Enumeration date
12/19/2005
Last updated
07/08/2007
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