Provider Demographics
NPI:1003476581
Name:MOSAD, PAUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:MOSAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BRANDON TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4728
Mailing Address - Country:US
Mailing Address - Phone:813-381-5858
Mailing Address - Fax:
Practice Address - Street 1:225 BRANDON TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4728
Practice Address - Country:US
Practice Address - Phone:813-381-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24924122300000X
OHRES.004125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist