Organization
DAVID A. MOSAL, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID A MOSAL DDS (PRESIDENT)
(601) 956-9595
Entity
Organization
Contact information
Practice address
5856 RIDGEWOOD RD, JACKSON, MS 39211-2617
(601) 956-9595
(601) 956-9883
Mailing address
5856 RIDGEWOOD RD, JACKSON, MS 39211-2617
(601) 956-9595
(601) 956-9883
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1585-73
MS
122300000X
Dentist
3475-08
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154463321
TYPE 1 NPI
MS
01
—
1972767143
TYPE 1 NPI
MS
Enumeration date
02/12/2013
Last updated
02/12/2013
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