Provider Demographics
NPI:1760916480
Name:STEVEN A. MOSKOWITZ DDS
Entity Type:Organization
Organization Name:STEVEN A. MOSKOWITZ DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERICAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-462-2424
Mailing Address - Street 1:1517 PACKER AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4910
Mailing Address - Country:US
Mailing Address - Phone:215-462-2424
Mailing Address - Fax:
Practice Address - Street 1:1517 PACKER AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-462-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018906L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty