Provider Demographics
NPI:1013211218
Name:MOSES, ROBERT N (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:MOSES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13447 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1273
Mailing Address - Country:US
Mailing Address - Phone:301-384-3630
Mailing Address - Fax:
Practice Address - Street 1:13447 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1273
Practice Address - Country:US
Practice Address - Phone:301-384-3630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7242122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist