Individual
BRONWYNN CLAIRE GIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RHD
Contact information
Practice address
800 OHIO AVE, CLARKSDALE, MS 38614-7200
(662) 624-2504
(662) 627-3629
Mailing address
510 HIGHWAY 322, CLARKSDALE, MS 38614-4717
(662) 624-2504
(662) 627-3629
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
372608DH
MS
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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