Provider Demographics
NPI:1770646788
Name:STEWART A. MOSS, D.D.S. AND ASSOCIATES P.C. DBA ALPHA DENTAL CARE
Entity Type:Organization
Organization Name:STEWART A. MOSS, D.D.S. AND ASSOCIATES P.C. DBA ALPHA DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-427-6462
Mailing Address - Street 1:421 W 104TH AVE
Mailing Address - Street 2:#201
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80234-4137
Mailing Address - Country:US
Mailing Address - Phone:303-427-6462
Mailing Address - Fax:303-487-7805
Practice Address - Street 1:421 W 104TH AVE
Practice Address - Street 2:#201
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-4137
Practice Address - Country:US
Practice Address - Phone:303-427-6462
Practice Address - Fax:303-487-7805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO403122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty