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Individual

RAYMOND KIMBLE DOTY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

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
1223P0221X
Pediatric Dentistry
Primary
2922
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00660144
MS
Enumeration date
11/28/2006
Last updated
03/14/2008
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