Provider Demographics
NPI:1316274897
Name:DEBORAH A. MOSES, D.D.S., INC.
Entity type:Organization
Organization Name:DEBORAH A. MOSES, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-674-5261
Mailing Address - Street 1:422 MARIANO BISHOP BLVD
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-2206
Mailing Address - Country:US
Mailing Address - Phone:508-674-5261
Mailing Address - Fax:508-674-0872
Practice Address - Street 1:422 MARIANO BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2206
Practice Address - Country:US
Practice Address - Phone:508-674-5261
Practice Address - Fax:508-674-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16636122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty