Individual
EDWARD MOUSSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2095 LINCOLN AVE # 201, ALTADENA, CA 91001-5478
(626) 639-8618
Mailing address
250 N COLLEGE PARK DR APT O12, UPLAND, CA 91786-9410
(734) 637-0368
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
106610
CA
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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