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Individual

DR. DANIEL BOBBY STORY II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5800 RIDGEWOOD RD, SUITE 101, JACKSON, MS 39211-2667
(601) 956-9850
(601) 956-9852
Mailing address
5800 RIDGEWOOD RD, SUITE 101, JACKSON, MS 39211-2667
(601) 956-9850
(601) 956-9852

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2202-85
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00060402
MS
Enumeration date
08/21/2006
Last updated
07/08/2007
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