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General NPI Number Information
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NPI Number | 1528796588
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Entity Type | Organization
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Legal Business Name | GARY J. MOSIO D.D.S.
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 17220 MACK AVE
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City | GROSSE POINTE
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State | MI
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Zip | 48230-6254
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Country | US
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Telephone | 313-881-9400
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Fax | 313-881-2736
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Provider Business Mailing Address
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Address Line | 17220 MACK AVE
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City | GROSSE POINTE
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State | MI
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Zip | 48230-6254
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Country | US
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Telephone | 313-881-9400
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Fax | 313-881-2736
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Authorized Official
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Title or Position | DENTIST
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Name | GARY J. MOSIO
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Credential | D.D.S.
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Telephone | 313-881-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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