Individual
STEPHEN L SURBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
401 HIGHWAY 11 S, ELLISVILLE, MS 39437-3103
(601) 477-3771
(601) 477-3747
Mailing address
401 HIGHWAY 11 S, ELLISVILLE, MS 39437-3103
(601) 477-3771
(601) 477-3747
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2366-87
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015325
—
MS
Enumeration date
01/10/2007
Last updated
06/29/2016
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