Provider Demographics
NPI:1124192455
Name:RONALD F MOSER, D.D.S., P.A.
Entity Type:Organization
Organization Name:RONALD F MOSER, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-464-3500
Mailing Address - Street 1:14300 GALLANT FOX LN
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4003
Mailing Address - Country:US
Mailing Address - Phone:301-464-3500
Mailing Address - Fax:301-262-3594
Practice Address - Street 1:14300 GALLANT FOX LN
Practice Address - Street 2:SUITE 208
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4003
Practice Address - Country:US
Practice Address - Phone:301-464-3500
Practice Address - Fax:301-262-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty