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General NPI Number Information
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NPI Number | 1578642864
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Entity Type | Individual
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Provider Name | BARBARA JOAN MIZELL DMD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 415 MOUNTAIN DR STE 4
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City | DESTIN
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State | FL
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Zip | 32541
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Country | US
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Telephone | 850-424-6996
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Fax | 850-424-6914
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Provider Business Mailing Address
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Address Line | 12 PLACE DE LA FONTAINE
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-4905
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Country | US
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Telephone | 850-393-3705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN12364
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License Number State | FL
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