Healthcare Provider Details

I. General information

NPI: 1801959812
Provider Name (Legal Business Name): JAMES DAVID BOUNDS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J DAVID BOUNDS DDS

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 MARVIN SHIELDS BLVD. NAVAL BRANCH HEALTH CLINIC
GULFPORT MS
39501
US

IV. Provider business mailing address

424 MELISSA DR.
BILOXI MS
39531
US

V. Phone/Fax

Practice location:
  • Phone: 228-871-2606
  • Fax: 228-388-9552
Mailing address:
  • Phone: 228-388-1032
  • Fax: 228-388-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number179378
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: