Provider Demographics
NPI:1962061259
Name:MOSHER, ERIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:MOSHER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-2101
Mailing Address - Country:US
Mailing Address - Phone:269-782-8161
Mailing Address - Fax:
Practice Address - Street 1:530 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-2101
Practice Address - Country:US
Practice Address - Phone:269-932-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016001771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice