MEDICARE: DR. PATRICK PAUL MOSELEY JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2914	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184662140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK PAUL MOSELEY JR. D.D.S.

Provider Business Mailing Address
First Line	:	305 N SPRING ST
Second Line	:
City	:	FORDYCE
State	:	AR
Zip	:	71742-3317
Country	:	US
Telephone Number	:	870-352-5161
Fax Number	:	870-352-7510

Provider Business Practice Location Address
First Line	:	305 N SPRING ST
Second Line	:
City	:	FORDYCE
State	:	AR
Zip	:	71742-3317
Country	:	US
Telephone Number	:	870-352-5161
Fax Number	:	870-352-7510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	05/14/2013

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Directions to “ DR. PATRICK PAUL MOSELEY JR. D.D.S.” Practice Location

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