Coastal Pediatric Dentistry, Llc
Dental Clinic/Center in Gulfport, MS(View on Map)
Legal Business Name
Coastal Pediatric Dentistry, Llc
NPI Number
1184167553
NPI Type
Organization
Enumeration Date
12/02/2016
Specialties
(Taxonomies)Licenses
State
Mississippi
License Number
3502-09
Contact
Information
Purpose
Mailing
Location
Address
1119 42ND AVE
1119 42ND AVE
City
Gulfport
Gulfport
State
MS
MS
Postal Code
39501-2664
39501-2664
Country
US
US
Telephone Number
(228) 864-8521
(228) 864-8521
Authorized Official
Name
Dr. Edward Brown
Title or Position
OWNER
Telephone Number
(504) 237-1203
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 12/02/2016
Provider Address
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