MEDICARE: DENISE E MOSELEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16289	TX

General Provider Information

NPI Number	:	1063541837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE E MOSELEY DDS

Provider Business Mailing Address
First Line	:	3301 STALCUP RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76119-1726
Country	:	US
Telephone Number	:	817-702-7185
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 STALCUP RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76119-1726
Country	:	US
Telephone Number	:	817-702-7185
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/05/2016

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Directions to “ DENISE E MOSELEY DDS” Practice Location

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