Organization
SOUTH MISSISSIPPI ORAL SURGERY & IMPLANT CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETT VAN YORK DDS (OWNER)
(601) 264-7611
Entity
Organization
Contact information
Practice address
12231 BERNARD PKWY, GULFPORT, MS 39503-5086
(601) 264-7611
(601) 268-0693
Mailing address
1421 S 28TH AVE, HATTIESBURG, MS 39402-3108
(601) 264-7611
(601) 268-0693
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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