Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 1795-78 | MS |
NPI | 1073727129 |
---|---|
Provider Name | Dr. Carney Ashley Brice III |
First Address | Biloxi, MS 39530-2908 |
Second Address | Biloxi, MS 39530-2908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 22/04/2013 |