Individual
KATRINA MOSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
570 E 115TH ST, CHICAGO, IL 60628-5740
(773) 768-5000
Mailing address
570 E 115TH ST, CHICAGO, IL 60628-5740
(773) 768-5000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.029990
IL
Other
Enumeration date
09/18/2014
Last updated
04/27/2021
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