Healthcare Provider Details

I. General information

NPI: 1912838764
Provider Name (Legal Business Name): DUNCAN F MATHESON III DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 INDIAN HILL BLVD
DIAMONDHEAD MS
39525-3334
US

IV. Provider business mailing address

5404 INDIAN HILL BLVD
DIAMONDHEAD MS
39525-3334
US

V. Phone/Fax

Practice location:
  • Phone: 228-255-2543
  • Fax:
Mailing address:
  • Phone: 228-255-2543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DUNCAN F MATHESON IV
Title or Position: DENTIST
Credential: DDS
Phone: 228-255-2543