Individual
DR. EMILE K MOUSSAED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1297 SHREVEPORT BARKSDALE HWY, SHREVEPORT, LA 71105-2405
(318) 865-8844
Mailing address
1002 ELMSMERE DR, NORTHVILLE, MI 48167-1065
(248) 449-8833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3845
WI
1223G0001X
General Practice Dentistry
Primary
6357
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901014893
DENTAL LICENSE
MI
05
—
33501200
—
WI
01
—
3845
DENTAL LICENSE
WI
Enumeration date
08/20/2006
Last updated
12/16/2013
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