Healthcare Provider Details

I. General information

NPI: 1073188017
Provider Name (Legal Business Name): SERENE ORAL SURGERY & IMPLANT SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 01/25/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6747 US HWY 98
HATTIESBURG MS
39402-8879
US

IV. Provider business mailing address

6747 US HWY 98
HATTIESBURG MS
39402-7052
US

V. Phone/Fax

Practice location:
  • Phone: 601-337-3822
  • Fax:
Mailing address:
  • Phone: 601-337-3822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CURTIS BISHOP
Title or Position: ORAL SURGEON
Credential: DMD, MD
Phone: 601-337-3822