Provider Demographics
NPI:1033294467
Name:MOSS, JAMES TAYLOR JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TAYLOR
Last Name:MOSS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:107 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38225-1440
Mailing Address - Country:US
Mailing Address - Phone:731-364-2215
Mailing Address - Fax:731-364-5565
Practice Address - Street 1:107 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:TN
Practice Address - Zip Code:38225-1440
Practice Address - Country:US
Practice Address - Phone:731-364-2215
Practice Address - Fax:731-364-5565
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000082491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice