Most Relevant Information
Provider Data
| NPI Number: | 1003594938 |
| Provider Name: | BARBARA DANIELA OLIVOS BAZAES DDS, MS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | PVRTP11923 |
Most Important Dates
| Enumeration Date: | 07/10/2023 |
| Last Updated: | 07/10/2023 |
Provider Practice Location
2500 N STATE ST
JACKSON
MS
392164500
Practice Location Phone/Fax
| Phone: | 6019846110 |
| Fax: |
Provider Mailing Location
206 COMSTOCK LN
MADISON
MS
391108364
Provider Mailing Phone/Fax
| Phone: | 7692535500 |
| Fax: |