MEDICARE: DR. ALLAN MOSKOW D.D.S.

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	1223E0200X	Endodontics	9289	FL

General Provider Information

NPI Number	:	1134274434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLAN MOSKOW D.D.S.

Provider Business Mailing Address
First Line	:	2240 W WOOLBRIGHT RD
Second Line	:	SUITE 410
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6332
Country	:	US
Telephone Number	:	561-738-6251
Fax Number	:	561-738-6296

Provider Business Practice Location Address
First Line	:	2240 W WOOLBRIGHT RD
Second Line	:	SUITE 410
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6332
Country	:	US
Telephone Number	:	561-738-6251
Fax Number	:	561-738-6296

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

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	07/08/2007

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