Provider Demographics
NPI:1194910844
Name:MOSER, RICK (DDS)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:
Last Name:MOSER
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 1:7409 W GRANDRIDGE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6710
Mailing Address - Country:US
Mailing Address - Phone:509-783-1335
Mailing Address - Fax:
Practice Address - Street 1:7409 W GRANDRIDGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6710
Practice Address - Country:US
Practice Address - Phone:509-783-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA610570971223E0200X
TX23489390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1223E0200XDental ProvidersDentistEndodontics