Individual
DR. MUNDY SCOTT BREAZEALE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
430 SECURITY SQ, GULFPORT, MS 39507-1952
(228) 896-7022
Mailing address
430 SECURITY SQ, GULFPORT, MS 39507-1952
(228) 896-7022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
271493
MS
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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