Organization
MITCHELL ORAL SURGERY AND IMPLANT CENTERS PA
Active
Other names
MOSAIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WAYNE MITCHELL D.D.S (OWNER)
(727) 842-5180
Entity
Organization
Contact information
Practice address
2535 LANDMARK DR STE 105, CLEARWATER, FL 33761-3930
(727) 791-6529
Mailing address
6731 MADISON ST, NEW PORT RICHEY, FL 34652-1928
(727) 842-5180
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN10802
FL
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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