Individual
LEWIS G MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1815 MONTAGUE AVENUE EXT, UNIT 1, GREENWOOD, SC 29649-7501
(864) 223-1152
Mailing address
1815 MONTAGUE AVENUE EXT, UNIT 1, GREENWOOD, SC 29649-7501
(864) 223-1152
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2124
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9604
—
SC
Enumeration date
10/10/2007
Last updated
10/10/2007
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