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General NPI Number Information
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NPI Number | 1568936888
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Entity Type | Organization
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Legal Business Name | JENNIFER D MOSS, RDHAP, INC
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Dates
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Enumeration Date | 01/21/2019
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Last Update Date | 01/21/2019
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Provider Practice Location Address
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Address Line | 33276 PALOMA RD
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City | MENIFEE
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State | CA
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Zip | 92584-9459
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Country | US
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Telephone | 951-252-4863
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Fax |
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Provider Business Mailing Address
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Address Line | 33276 PALOMA RD
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City | MENIFEE
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State | CA
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Zip | 92584-9459
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Country | US
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Telephone | 951-252-4863
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JENNIFER D MOSS
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Credential | BS,RDH,RDHAP
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Telephone | 951-252-4863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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