Individual
DR. MIRRIAL JANE MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1039 11TH ST, AUGUSTA, GA 30901-2873
(706) 722-4008
(706) 722-8833
Mailing address
1039 11TH ST, AUGUSTA, GA 30901-2873
(706) 722-4008
(706) 722-8833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN010270
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00315246A
—
GA
Enumeration date
10/19/2006
Last updated
07/08/2007
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