Individual
DR. MICHAEL DAVID FAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-6001
(601) 815-3903
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 984-6001
(662) 651-7115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2269-86
MS
Other
Enumeration date
01/22/2007
Last updated
03/07/2023
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