Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 9289 | FL |
NPI | 1134274434 |
---|---|
Provider Name | Dr. Allan Moskow |
First Address | Boynton Beach, FL 33426-6332 |
Second Address | Boynton Beach, FL 33426-6332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 08/07/2007 |