Individual
EVAN REED SOBIESK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1421 S 28TH AVE, HATTIESBURG, MS 39402-3108
(601) 264-7611
Mailing address
1421 S 28TH AVE, HATTIESBURG, MS 39402-3108
(601) 264-7611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4160-20
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4160-20
MS
Other
Enumeration date
04/26/2020
Last updated
06/04/2024
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