Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 2259 | MT |
NPI | 1154582401 |
---|---|
Provider Name | Dr. Erin A Moseley |
First Address | Kalispell, MT 59901-2665 |
Second Address | Kalispell, MT 59901-2665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 02/06/2020 |