Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 3197 | CO |
NPI | 1548269269 |
---|---|
Provider Name | Dr. James B. Moses |
First Address | Denver, CO 80222-5432 |
Second Address | Denver, CO 80222-5406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 08/07/2007 |