Organization
MISSISSIPPI DENTAL ARTS
Active
Other names
PC Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD WILLIAM FAVRE III DDS (DENTIST/OWNER)
(228) 254-1212
Entity
Organization
Contact information
Practice address
121 E SECOND ST, PASS CHRISTIAN, MS 39571-4442
(228) 254-1212
(228) 254-1213
Mailing address
121 E SECOND ST, PASS CHRISTIAN, MS 39571-4442
(228) 254-1212
(228) 254-1213
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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