Harbor View Oral And Facial Surgery Llc

NPI 1063781086 - Dentist - 1223S0112X

NPI Details
NPI 1063781086
Enumeration Date 12/20/2011
Last Updated 12/20/2011
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name JASON O JASON
Position OWNER/PROVIDER
Phone (228) 867-0121
Fax (228) 867-0252
Practice Location
1301 25TH AVENUE
SUITE 3
GULFPORT MS, 39501, US
Phone (228) 867-0121
Fax (228) 867-0252
Business Location
1301 25TH AVENUE
SUITE 3
GULFPORT MS, 39501, US
Phone (228) 867-0121
Fax (228) 867-0252
Toxanomy
Taxonomy Code 1223S0112X
License State Mississippi
License Number 335805
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According to our database, Harbor View Oral And Facial Surgery Llc NPI is 1063781086, taxonomy code is 1223S0112X and license number is 335805, license state is located at Mississippi. Harbor View Oral And Facial Surgery Llc physically located at 1301 25th Avenue, Gulfport MS, 39501. NPI Number 1033115704 has the healthcare provider type.

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1063781086 NPI number is provided on an as is basis without warranty of any kind. 1063781086 is maintained by the National Plan & Provider Enumeration System. The contents of Harbor View Oral And Facial Surgery Llc are for informational purposes only.