Organization
GULF ISLANDS DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL PARKER D.M.D. (PRESIDENT)
(228) 769-9010
Entity
Organization
Contact information
Practice address
1226 JACKSON AVE, PASCAGOULA, MS 39567-4348
(228) 769-9010
(228) 762-0303
Mailing address
1226 JACKSON AVE, PASCAGOULA, MS 39567-4348
(228) 769-9010
(228) 762-0303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
333605
MS
122300000X
Dentist
375014
MS
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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