Provider Demographics
NPI:1184711830
Name:MOSCATTINI, ROY CANZIO (DDS)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:CANZIO
Last Name:MOSCATTINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 HOWELL FERRY RD
Mailing Address - Street 2:BLDG A
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096
Mailing Address - Country:US
Mailing Address - Phone:770-476-4144
Mailing Address - Fax:770-813-8025
Practice Address - Street 1:3660 HOWELL FERRY RD
Practice Address - Street 2:BLDG A
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:770-476-4144
Practice Address - Fax:770-813-8025
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11526122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist