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General NPI Number Information
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NPI Number | 1578585717
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Entity Type | Individual
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Provider Name | RICHARD L MOSS DDS
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 6099 N 1ST ST SUITE 104
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City | FRESNO
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State | CA
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Zip | 93710-5462
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Country | US
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Telephone | 559-431-1400
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Fax | 559-431-1590
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Provider Business Mailing Address
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Address Line | 1140 MAIN ST SUITE 104
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City | LIVINGSTON
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State | CA
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Zip | 95334-1257
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Country | US
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Telephone | 209-394-1385
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Fax | 209-394-9093
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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 | 26900
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License Number State | CA
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