Individual
ANDREW W MOSELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2063 WILMA RUDOLPH BLVD, CLARKSVILLE, TN 37040-6621
(931) 552-1302
(931) 552-4755
Mailing address
PO BOX 30039, CLARKSVILLE, TN 37040-0001
(931) 552-1302
(931) 552-4755
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3259
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008920
BLUE CROSS BLUE SHIELD
TN
01
—
800959
UNITED CONCORDIA
PA
Enumeration date
10/27/2006
Last updated
07/08/2007
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