Individual
JASON FRANKLIN OLAIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1311 BEARDS COVE, GULFPORT, MS 39507-3600
(228) 223-1445
Mailing address
1311 BEARDS COVE DR, GULFPORT, MS 39507-3600
(228) 223-1445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3911-17
MS
Other
Enumeration date
04/05/2017
Last updated
04/06/2017
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