Provider Demographics
NPI:1235497272
Name:JAMES MOSHIER, DMD, LLC
Entity Type:Organization
Organization Name:JAMES MOSHIER, DMD, LLC
Other - Org Name:PLEASANT STREET DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHIER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-725-2062
Mailing Address - Street 1:53 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2262
Mailing Address - Country:US
Mailing Address - Phone:207-725-2062
Mailing Address - Fax:
Practice Address - Street 1:53 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2262
Practice Address - Country:US
Practice Address - Phone:207-725-2062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN42381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty