Individual
MARK W GILBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6889 HIGHWAY 305 N, OLIVE BRANCH, MS 38654-2317
(662) 895-0100
Mailing address
6889 HIGHWAY 305 N, OLIVE BRANCH, MS 38654-2317
(662) 895-0100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2483-89
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060470
—
MS
Enumeration date
10/23/2006
Last updated
07/09/2007
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