Individual
DR. ANDREA RENAE GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1316 25TH AVE LOWR LEVEL, MERIDIAN, MS 39301-3916
(601) 693-7913
(601) 483-2217
Mailing address
1426 SUMMER SEAT RD, VICKSBURG, MS 39183-9270
(601) 693-7918
(601) 483-2217
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3155-00
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660373
—
MS
Enumeration date
09/03/2006
Last updated
07/09/2007
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