Individual
DR. FREDERICK JON MOFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
848 PITTSBURGH ST, SPRINGDALE, PA 15144-1640
(724) 274-5411
(724) 274-5412
Mailing address
848 PITTSBURGH ST, SPRINGDALE, PA 15144-1640
(724) 274-5411
(724) 274-5412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-026279-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS-026279-L
PA STATE DENTAL LICENSE
PA
Enumeration date
12/30/2006
Last updated
07/08/2007
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