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General NPI Number Information
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NPI Number | 1811244791
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Entity Type | Individual
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Provider Name | MICHAEL DAVID HOSKING DDS
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Gender | Male
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 5600 PORADA DR STE 102
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City | MELBOURNE
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State | FL
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Zip | 32940-8082
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Country | US
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Telephone | 321-754-9988
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Fax | 321-754-9988
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Provider Business Mailing Address
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Address Line | 4978 DUSON WAY
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City | ROCKLEDGE
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State | FL
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Zip | 32955-7003
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Country | US
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Telephone |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30798
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN23144
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License Number State | FL
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