Provider Demographics
NPI:1154603520
Name:DRS. MOSS AND SANG LLC
Entity type:Organization
Organization Name:DRS. MOSS AND SANG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-669-5687
Mailing Address - Street 1:614 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4302
Mailing Address - Country:US
Mailing Address - Phone:843-669-5687
Mailing Address - Fax:843-669-0161
Practice Address - Street 1:614 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4302
Practice Address - Country:US
Practice Address - Phone:843-669-5687
Practice Address - Fax:843-669-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty