Provider Demographics
NPI:1275673618
Name:MOSBY, STEVE MARQUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:MARQUIS
Last Name:MOSBY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 W MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2449
Mailing Address - Country:US
Mailing Address - Phone:406-535-2084
Mailing Address - Fax:406-535-2087
Practice Address - Street 1:821 W MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457
Practice Address - Country:US
Practice Address - Phone:406-535-2084
Practice Address - Fax:406-535-2087
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2382122300000X
CA313361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTDP 2382OtherDP 2382
CADP 31336OtherLICENSE NUMBER