MEDICARE: DR. MITCHELL ALLEN JOSEPHS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN 13228	FL

General Provider Information

NPI Number	:	1326168105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL ALLEN JOSEPHS DDS

Provider Business Mailing Address
First Line	:	44 COCOANUT ROW
Second Line	:
City	:	PALM BEACH
State	:	FL
Zip	:	33480-4069
Country	:	US
Telephone Number	:	561-832-4675
Fax Number	:	561-832-7018

Provider Business Practice Location Address
First Line	:	44 COCOANUT ROW
Second Line	:
City	:	PALM BEACH
State	:	FL
Zip	:	33480-4069
Country	:	US
Telephone Number	:	561-832-4675
Fax Number	:	561-832-7018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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