Individual
ANKIT BAVARIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDS
Contact information
Practice address
15921 BOUNDARY DR, ASHLAND, MS 38603
(662) 224-8951
Mailing address
15921 BOUNDARY DR, ASHLAND, MS 38603-7740
(662) 224-8951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3722-13
MS
1223P0300X
Periodontics
Primary
3722-13
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07156851
—
MS
Enumeration date
09/14/2010
Last updated
07/16/2018
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