Organization
GAMBLIN ORTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERSON R GAMBLIN (MEMBER)
(601) 894-4732
Entity
Organization
Contact information
Practice address
240 CALDWELL DR, HAZLEHURST, MS 39083-2723
(601) 894-4732
Mailing address
PO BOX 587, HAZLEHURST, MS 39083-0587
(601) 894-4732
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR 431-10
MS
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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