Provider Demographics
NPI:1356404230
Name:MOSES, SCOTT BENNETT (DVM)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BENNETT
Last Name:MOSES
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1213
Mailing Address - Country:US
Mailing Address - Phone:973-625-5300
Mailing Address - Fax:973-625-7537
Practice Address - Street 1:279 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1213
Practice Address - Country:US
Practice Address - Phone:973-625-5300
Practice Address - Fax:973-625-7537
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29V100195100174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian