Provider Demographics
NPI:1407859325
Name:WINN, FRANK O (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:O
Last Name:WINN
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:4551 GAUTIER VANCLEAVE RD
Mailing Address - Street 2:STE A
Mailing Address - City:GAUTIER
Mailing Address - State:MS
Mailing Address - Zip Code:39553-4810
Mailing Address - Country:US
Mailing Address - Phone:228-497-6110
Mailing Address - Fax:228-497-7092
Practice Address - Street 1:4551 GAUTIER VANCLEAVE RD
Practice Address - Street 2:STE A
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-4810
Practice Address - Country:US
Practice Address - Phone:228-497-6110
Practice Address - Fax:228-497-7092
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS1917-801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS41474OtherUNITED CONCORDIA