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General NPI Number Information
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NPI Number | 1710904669
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Entity Type | Organization
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Legal Business Name | DR RONALD A MOSS PA
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 451 RUIN CREEK ROAD SUITE 105
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City | HENDERSON
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State | NC
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Zip | 27536
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Country | US
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Telephone | 252-492-3355
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Fax | 252-492-9938
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Provider Business Mailing Address
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Address Line | 451 RUIN CREEK ROAD SUITE 105
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City | HENDERSON
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State | NC
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Zip | 27536
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Country | US
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Telephone | 252-492-3355
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Fax | 252-492-9938
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Authorized Official
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Title or Position | DDS
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Name | DR. RONALD A MOSS
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Credential |
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Telephone | 252-492-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 3851
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License Number State | NC
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