Provider Demographics
NPI:1902024110
Name:MOSLING, MICHAEL STEVEN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STEVEN
Last Name:MOSLING
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 JACKSON ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-5800
Mailing Address - Country:US
Mailing Address - Phone:608-782-1950
Mailing Address - Fax:608-782-1959
Practice Address - Street 1:1800 JACKSON ST
Practice Address - Street 2:SUITE D
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-5800
Practice Address - Country:US
Practice Address - Phone:608-782-1950
Practice Address - Fax:608-782-1959
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46681223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics