Individual
DR. KEVIN SCOTT DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1603 23RD AVE, MERIDIAN, MS 39301-3102
(601) 483-4522
(601) 485-9925
Mailing address
1603 23RD AVE, MERIDIAN, MS 39301-3102
(601) 483-4522
(601) 485-9925
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3022-97
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN 17395
FL
Other
Enumeration date
07/20/2007
Last updated
01/13/2011
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