Provider Demographics
NPI:1649345844
Name:MOSLANDER-THOMPSON, AMY H (DDS)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:H
Last Name:MOSLANDER-THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9633 MARKET PL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-7944
Mailing Address - Country:US
Mailing Address - Phone:425-397-8888
Mailing Address - Fax:
Practice Address - Street 1:9633 MARKET PL
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-7944
Practice Address - Country:US
Practice Address - Phone:425-397-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000100001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice