Individual
DR. LESLIE BREWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
707 LAUREL STREET, SUMMIT, MS 39666-0759
(601) 276-9561
(601) 276-9562
Mailing address
PO BOX 759, 707 LAUREL ST., SUMMIT, MS 39666-0759
(601) 276-9561
(601) 276-9562
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3289-04
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01258242
—
MS
Enumeration date
08/03/2006
Last updated
07/08/2007
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