Provider Demographics
NPI:1285433177
Name:MOSS, JEFFREY HOWARD (DDS, CNS, DACBN)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOWARD
Last Name:MOSS
Suffix:
Gender:
Credentials:DDS, CNS, DACBN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HIGH MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9764
Mailing Address - Country:US
Mailing Address - Phone:413-530-0858
Mailing Address - Fax:
Practice Address - Street 1:11 HIGH MEADOW RD
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9764
Practice Address - Country:US
Practice Address - Phone:413-530-0858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist