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General NPI Number Information
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NPI Number | 1154379097
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Entity Type | Individual
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Provider Name | MARK EUGENE MOSIER DDS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 104 E WASHINGTON ST
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City | CLARINDA
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State | IA
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Zip | 51632-1611
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Country | US
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Telephone | 712-542-5196
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Fax |
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Provider Business Mailing Address
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Address Line | 634 LOWER TURTLE CREEK RD
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City | KERRVILLE
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State | TX
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Zip | 78028-8096
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Country | US
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Telephone | 830-928-7300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7212
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License Number State | IA
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