Individual
DR. TINA PERRY MOSES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1240 AUGUSTA WEST PKWY, AUGUSTA, GA 30909-1854
(706) 863-6262
(706) 863-6465
Mailing address
988 WINDMILL PKWY, EVANS, GA 30809-6664
(706) 863-4524
(706) 863-4524
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012036
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZG2036
—
SC
Enumeration date
06/06/2006
Last updated
07/09/2007
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