Individual
DR. JASON KOTERO BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
2700 N HILLS ST, MERIDIAN, MS 39305-2641
(601) 485-4851
Mailing address
81 SUNNYBROOK CIR, VICKSBURG, MS 39180-9322
(601) 899-2414
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3833-15
MS
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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