Individual
JACOB BRIAN MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7632 S CAMPUS VIEW DR STE 150, WEST JORDAN, UT 84084-5545
(801) 282-4142
Mailing address
2924 S GARDEN MEADOWS CV, SOUTH SALT LAKE, UT 84106-1302
(801) 884-9386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14004167-9926
UT
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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