Provider Demographics
NPI:1558326728
Name:MOSES, HOWARD S (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:S
Last Name:MOSES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1361
Mailing Address - Country:US
Mailing Address - Phone:732-499-7300
Mailing Address - Fax:732-499-7326
Practice Address - Street 1:817 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1361
Practice Address - Country:US
Practice Address - Phone:732-499-7300
Practice Address - Fax:732-499-7326
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist