Organization
RUSSELL N MOSHER DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL N MOSHER DDS (OWNER)
(804) 379-6971
Entity
Organization
Contact information
Practice address
1320 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 379-6971
(804) 379-2796
Mailing address
1320 ALVERSER PLZ, MIDLOTHIAN, VA 23113-2604
(804) 379-6971
(804) 379-2796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401007113
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089260
ANTHEM
VA
01
—
683606
UNITED CONCORDIA
VA
Enumeration date
12/06/2006
Last updated
10/20/2016
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