Individual
DR. CLARENCE RENSHAW AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5106 TELEPHONE RD, PASCAGOULA, MS 39567-1120
(228) 762-9123
(228) 762-9123
Mailing address
PO BOX 405, PASCAGOULA, MS 39568-0405
(228) 762-9123
(228) 762-9123
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1819-78
MS
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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