Individual
DR. RICHARD LEWIS MOUSSALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
115 S PHELPS ST, DECATUR, MI 49045-1117
(269) 423-4961
(269) 423-8927
Mailing address
115 S PHELPS ST, DECATUR, MI 49045-1117
(269) 423-4961
(269) 423-8927
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014648
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1844602
—
MI
Enumeration date
12/20/2006
Last updated
07/08/2007
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