Individual
DR. MARK L MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8636 N 59TH AVE, GLENDALE, AZ 85302-5404
(623) 937-3500
Mailing address
8636 N 59TH AVE, GLENDALE, AZ 85302-5404
(623) 937-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27658
CA
1223G0001X
General Practice Dentistry
Primary
D7452
AZ
Other
Enumeration date
04/16/2008
Last updated
10/24/2014
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