Provider Demographics
NPI:1972130672
Name:MOSIER, MEREDITH RAE (DDS)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:RAE
Last Name:MOSIER
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 1:421 W 3RD ST APT 811
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-4166
Mailing Address - Country:US
Mailing Address - Phone:281-973-0833
Mailing Address - Fax:
Practice Address - Street 1:421 W 3RD ST APT 811
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-4166
Practice Address - Country:US
Practice Address - Phone:281-973-0833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX353731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice