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Individual

LEE D GARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
102 E. PINEVIEW DR., FLOWOOD, MS 39232
(601) 992-1285
(601) 992-6526
Mailing address
102 E. PINEVIEW DR., FLOWOOD, MS 39232
(601) 992-1285
(601) 992-6526

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3328-05
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05373770
MS
Enumeration date
04/17/2007
Last updated
07/08/2007
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