Organization
GULF COAST ENDODONTIC ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT BONSON DDS (OWNER)
(228) 265-7061
Entity
Organization
Contact information
Practice address
460 SECURITY SQ, GULFPORT, MS 39507-1952
(228) 265-7061
(228) 254-1342
Mailing address
423 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 265-7061
(228) 254-1342
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
10/29/2018
Last updated
01/23/2023
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