Individual
DR. LISA MAURIOCOURT MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
24144 WESTMONT DR, NOVI, MI 48374-3660
(248) 797-8632
Mailing address
24144 WESTMONT DR, NOVI, MI 48374-3660
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017865
MI
1223G0001X
General Practice Dentistry
3001
SC
1223G0001X
General Practice Dentistry
DN010855
GA
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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