Provider Demographics
NPI:1811244791
Name:HOSKING, MICHAEL DAVID (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:HOSKING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4978 DUSON WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-7003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5600 PORADA DR STE 102
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8082
Practice Address - Country:US
Practice Address - Phone:321-754-9988
Practice Address - Fax:321-754-9988
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307981223E0200X
FLDN231441223E0200X
TXETN91390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program