Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 07077 | IA |
NPI | 1467455451 |
---|---|
Provider Name | Dr. David Lloyd Moss |
First Address | Gaithersburg, MD 20886-3127 |
Second Address | Gaithersburg, MD 20886-3127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |