# JOSEPH MOSS DDS & TYLER TEBAY DMD PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Olympia Advanced Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912167248
- **Authorized official:** DAWN QUESADA (OFFICE MANAGER/ADMINISTRATOR)
- **Authorized official phone:** (360) 357-8075

## Contact information

- **Practice address:** 1105 4TH AVE E, SUITE A, OLYMPIA, WA 98506-4018
- **Practice address phone:** (360) 357-8075
- **Practice address fax:** (360) 357-3842
- **Mailing address:** 1105 4TH AVE E, SUITE A, OLYMPIA, WA 98506-4018
- **Mailing address phone:** (360) 357-8075
- **Mailing address fax:** (360) 357-3842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00006116 | WA | Yes |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 07/31/2023