Individual
BRYANT HIRSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
785 OHIO AVE STE 3H, CLARKSDALE, MS 38614-6215
(662) 627-9001
(662) 627-3662
Mailing address
785 OHIO AVE STE 3H, CLARKSDALE, MS 38614-6215
(662) 627-9001
(662) 627-3662
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3042-98
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR-345-00
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660374
—
MS
Enumeration date
10/16/2006
Last updated
04/27/2018
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