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HARBOR VIEW ORAL AND FACIAL SURGERY LLC NPI 1063781086


NPI Information

NPI: 1063781086
Provider Name: HARBOR VIEW ORAL AND FACIAL SURGERY LLC

Doing Business As: HARBORVIEW ORAL AND FACIAL SURGERY CENTER

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1301 25TH AVENUE
SUITE 3
GULFPORT, MS
ZIP 39501
Phone: (228) 867-0121
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HARBOR VIEW ORAL AND FACIAL SURGERY LLC is an oral and maxillofacial surgery dentist in Gulfport, MS. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. HARBOR VIEW ORAL AND FACIAL SURGERY LLC NPI is 1063781086. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Harborview Oral And Facial Surgery Center.

The provider's business location address is:

1301 25TH AVENUE
SUITE 3
GULFPORT, MS
ZIP 39501
Phone: (228) 867-0121
Fax: (228) 867-0252

The provider's authorized official is Jason O Rosetti .
The authorized official title is Owner/provider and has the following contact phone number (228) 867-0121.

The enumeration date for this NPI number is 12/20/2011 and was last updated on 12/20/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial Surgery335805MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103520709MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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