# MITCHELL ORAL SURGERY AND IMPLANT CENTERS PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MOSAIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003287129
- **Authorized official:** DR. MARK WAYNE MITCHELL D.D.S (OWNER)
- **Authorized official phone:** (727) 842-5180

## Contact information

- **Practice address:** 2535 LANDMARK DR STE 105, CLEARWATER, FL 33761-3930
- **Practice address phone:** (727) 791-6529
- **Mailing address:** 6731 MADISON ST, NEW PORT RICHEY, FL 34652-1928
- **Mailing address phone:** (727) 842-5180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN10802 | FL | Yes |

## Other

- **Enumeration date:** 10/15/2015
- **Last updated:** 10/15/2015