Provider Demographics
NPI:1154582401
Name:MOSELEY, ERIN A (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:A
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FOUR MILE DR
Mailing Address - Street 2:#15
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2665
Mailing Address - Country:US
Mailing Address - Phone:406-257-3647
Mailing Address - Fax:406-257-3675
Practice Address - Street 1:80 FOUR MILE DR
Practice Address - Street 2:#15
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2665
Practice Address - Country:US
Practice Address - Phone:406-257-3647
Practice Address - Fax:406-257-3675
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22591223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics