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General NPI Number Information
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NPI Number | 1073188017
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Entity Type | Organization
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Legal Business Name | SERENE ORAL SURGERY & IMPLANT SPECIALISTS, PLLC
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 6747 US HWY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-8879
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Country | US
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Telephone | 601-337-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 6747 US HWY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-7052
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Country | US
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Telephone | 601-337-3822
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Fax |
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. CURTIS BISHOP
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Credential | DMD, MD
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Telephone | 601-337-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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