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Organization

DR. DALE J MOSER OD

Active
Parent organization
DR. DALE J MOSER O.D.
Other names
Beaverton Family Eyecare
Organization subpart
Yes

Provider details

NPI number
Legal business name
DR. DALE J MOSER O.D.
Authorized official
DR. DALE JAMES MOSER O.D. (OWNER)
(989) 386-2020
Entity
Organization

Contact information

Practice address
334 N ROSS, BEAVERTON, MI 48612
(989) 435-2020
(989) 435-2554
Mailing address
1520 B N MCEWAN ST, CLARE, MI 48617
(989) 386-2020
(989) 386-7308

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003085
MI
332H00000X
Eyewear Supplier
003085
MI
332H00000X
Eyewear Supplier
004640
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1908862
MI
01
410008233
RAILROAD MEDICARE
MI
01
900A86500
BC/BS
MI
Enumeration date
01/03/2008
Last updated
04/03/2012
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