Provider Demographics
NPI:1275645970
Name:MOSER-KIM, NOEL CATHERINE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:CATHERINE
Last Name:MOSER-KIM
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17115 ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-7820
Mailing Address - Country:US
Mailing Address - Phone:858-200-6178
Mailing Address - Fax:
Practice Address - Street 1:17115 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-7820
Practice Address - Country:US
Practice Address - Phone:858-200-6178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics