Organization
HARBOR VIEW ORAL AND FACIAL SURGERY LLC
Active
Other names
Harborview Oral and Facial Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON O ROSETTI DDS (OWNER/PROVIDER)
(228) 867-0121
Entity
Organization
Contact information
Practice address
1301 25TH AVENUE, SUITE 3, GULFPORT, MS 39501
(228) 867-0121
(228) 867-0252
Mailing address
1301 25TH AVENUE, SUITE 3, GULFPORT, MS 39501
(228) 867-0121
(228) 867-0252
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
335805
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03520709
—
MS
Enumeration date
12/20/2011
Last updated
12/20/2011
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