Individual
DR. GERALD WILLIAM FAVRE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 E SECOND ST, PASS CHRISTIAN, MS 39571-4442
(228) 697-6230
Mailing address
121 E SECOND ST, PASS CHRISTIAN, MS 39571-4442
(228) 254-1212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4233-21
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2018
Last updated
08/11/2022
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