Provider Demographics
NPI:1720492283
Name:HOWARD W. MOY,DDS,APC
Entity Type:Organization
Organization Name:HOWARD W. MOY,DDS,APC
Other - Org Name:HI-COUNTRY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:WONG
Authorized Official - Last Name:MOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-241-8181
Mailing Address - Street 1:13186 AMARGOSA RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-8503
Mailing Address - Country:US
Mailing Address - Phone:760-241-8181
Mailing Address - Fax:760-241-2218
Practice Address - Street 1:13186 AMARGOSA RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8503
Practice Address - Country:US
Practice Address - Phone:760-241-8181
Practice Address - Fax:760-241-2218
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWARD W. MOY,DDS,APC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-12
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
CA33635305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33635-01OtherDENTI-CAL