Organization
HARVEY MOSSAK ORAL & MAXILLOFACIAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARVEY MOSSAK DMD (ORAL SURGEON)
(973) 572-0599
Entity
Organization
Contact information
Practice address
1211 E KENNEDY BLVD UNIT 223, TAMPA, FL 33602-3559
(972) 572-0599
(813) 654-7824
Mailing address
1211 E KENNEDY BLVD UNIT 223, TAMPA, FL 33602-3559
(972) 572-0599
(813) 654-7824
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
631YO
FLORIDA BLUE
FL
Enumeration date
11/30/2018
Last updated
11/30/2018
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