Individual
DR. SAMUEL R, MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
217 E KALISTE SALOOM RD, SUITE 100, LAFAYETTE, LA 70508-8513
(337) 232-9937
(337) 232-1172
Mailing address
217 E KALISTE SALOOM RD, SUITE 100, LAFAYETTE, LA 70508-8513
(337) 232-9937
(337) 232-1172
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3574
LA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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