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Organization

COASTAL JAW SURGERY OF NEW PORT RICHEY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK W MITCHELL DDS (PRESIDENT)
(727) 842-5180
Entity
Organization

Contact information

Practice address
6731 MADISON ST, NEW PORT RICHEY, FL 34652-1928
(727) 842-5180
(727) 846-0755
Mailing address
6731 MADISON ST, NEW PORT RICHEY, FL 34652-1928
(727) 842-5180
(727) 846-0755

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
12/31/2007
Last updated
09/12/2008
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