Provider Demographics
NPI:1679844195
Name:DRS. MOSS & OWEN INC.
Entity Type:Organization
Organization Name:DRS. MOSS & OWEN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:UNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-432-2155
Mailing Address - Street 1:PO BOX 1647
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29021-8647
Mailing Address - Country:US
Mailing Address - Phone:803-432-2155
Mailing Address - Fax:803-432-7744
Practice Address - Street 1:310 HAMPTON PARK
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-3605
Practice Address - Country:US
Practice Address - Phone:803-432-2155
Practice Address - Fax:803-432-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty