Provider Demographics
NPI:1942376181
Name:MOSS, BARRY ALLYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALLYN
Last Name:MOSS
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 1:310 N LANCASTER ST
Mailing Address - Street 2:PO BOX 687
Mailing Address - City:JONESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17038-8909
Mailing Address - Country:US
Mailing Address - Phone:717-865-5211
Mailing Address - Fax:717-865-6047
Practice Address - Street 1:310 N LANCASTER ST
Practice Address - Street 2:
Practice Address - City:JONESTOWN
Practice Address - State:PA
Practice Address - Zip Code:17038-8909
Practice Address - Country:US
Practice Address - Phone:717-865-5211
Practice Address - Fax:717-865-5211
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-029748-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist