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NPI 1164446902

NPI 1164446902 : ALEXANDER EUGENE MOSER DDS : WINSTON SALEM, NC

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General NPI Number Information
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    NPI Number           |    1164446902
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDER EUGENE MOSER DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/26/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    116 JONESTOWN RD 
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    City                 |    WINSTON SALEM
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    State                |    NC
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    Zip                  |    27104-4617
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    Country              |    US
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    Telephone            |    336-768-7495
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    Fax                  |    336-768-7499
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Provider Business Mailing Address
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    Address Line         |    8333 TUSCANY DR 
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    City                 |    LEWISVILLE
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    State                |    NC
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    Zip                  |    27023-9473
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    Country              |    US
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    Telephone            |    336-946-2839
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    Fax                  |    336-768-7499
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    4381NC
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    License Number State |    NC
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