Individual
WADE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
232A EISENHOWER DR, BILOXI, MS 39531-3601
(228) 388-9551
Mailing address
PO BOX 1053, GULFPORT, MS 39502-1053
(228) 860-6860
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2002-83
MS
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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