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Individual
DR. WALTER CARL MOSES III
Active
Individual
DR. WALTER CARL MOSES III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
3793-15
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07720764
—
MS
Enumeration date
03/24/2015
Last updated
10/15/2019
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