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Individual

DR. JERRY QUINTON GLIDER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1311 S 28TH AVE, HATTIESBURG, MS 39402
(601) 264-4800
(601) 268-0392
Mailing address
1311 S 28TH AVE, HATTIESBURG, MS 39402
(601) 264-4800
(601) 268-0392

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
175277
MS

Other

Enumeration date
02/28/2006
Last updated
07/08/2007
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