Organization
R KIMBLE DOTY, JR DDS,MS PEDIATRIC DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R KIMBLE DOTY D.D.S., M.S. (PRESIDENT)
(228) 864-8521
Entity
Organization
Contact information
Practice address
1119 42ND AVE, GULFPORT, MS 39501-2664
(228) 864-8521
(228) 863-8992
Mailing address
1119 42ND AVE, GULFPORT, MS 39501-2664
(228) 864-8521
(228) 863-8992
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2922
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07450231
—
MS
Enumeration date
11/28/2006
Last updated
08/22/2020
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