Provider Demographics
NPI:1033557202
Name:MOSER, LINDSAY BROOKE (RDH)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BROOKE
Last Name:MOSER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11488 COUNTY ROAD 41
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:CO
Mailing Address - Zip Code:80642-9618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11488 COUNTY ROAD 41
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:CO
Practice Address - Zip Code:80642-9618
Practice Address - Country:US
Practice Address - Phone:303-472-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904097124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist