Provider Demographics
NPI:1073727129
Name:BRICE, CARNEY ASHLEY III
Entity Type:Individual
Prefix:DR
First Name:CARNEY
Middle Name:ASHLEY
Last Name:BRICE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 JUDGE SEKUL AVE
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-2908
Mailing Address - Country:US
Mailing Address - Phone:228-374-8175
Mailing Address - Fax:228-436-4333
Practice Address - Street 1:1070 JUDGE SEKUL AVE
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-2908
Practice Address - Country:US
Practice Address - Phone:228-374-8175
Practice Address - Fax:228-436-4333
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1795-781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry