Individual
JOSEPH TYLER LEVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1621 PASS RD, SUITE C, BILOXI, MS 39531-4341
(228) 436-4401
Mailing address
1621 PASS RD, SUITE C, BILOXI, MS 39531-4341
(228) 436-4401
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3631-12
MS
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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