Coastal Jaw Surgery Of New Port Richey, P.A.
LBN: Coastal Jaw Surgery Of New Port Richey, P.A.
Coastal Jaw Surgery Of New Port Richey, P.A. is an health care organization with primary practice located at 2720 Park Dr , Clearwater FL 33763-1020. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty.
Coastal Jaw Surgery Of New Port Richey, P.A. can be contacted via phone (727) 726-8500, or through Mitchell, Mark Wayne via phone (727) 842-5180.
Contact Information
Primary practice address
2720 Park Dr
Clearwater FL 33763-1020
Phone: (727) 726-8500
Fax: (727) 725-9716
Website:
Authorized official contact:
Name: Mitchell, Mark Wayne Doctor of Dental Surgery (DDS)
Phone: (727) 842-5180
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN10802 | Florida |
Profile Details
| NPI number | 1710131826 |
|---|---|
| LBN Legal business name | Coastal Jaw Surgery Of New Port Richey, P.A. |
| DBA Doing business as | |
| Authorized official | Mitchell, Mark Wayne Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 17th, 2008 |
| Last updated | Nov 17th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710131826 | NPPES |
| Florida | MEDICAID | 072932900 |
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