Individual
KATELYN R MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDH
Contact information
Practice address
3118 S LAFOUNTAIN ST, KOKOMO, IN 46902-3710
(765) 864-4160
Mailing address
1712 S ARMSTRONG ST, KOKOMO, IN 46902-2034
(765) 667-1139
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13007458A
IN
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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