Individual
DR. DEE DENNIS MOSHOS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
34 LAKE HAVASU AVE N STE 5, LAKE HAVASU CITY, AZ 86403-5639
(929) 453-5577
(928) 453-1661
Mailing address
34 LAKE HAVASU AVE N STE 5, LAKE HAVASU CITY, AZ 86403-5639
(929) 453-5577
(928) 453-1661
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3216
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0418650
BLUE CROSS BLUE SHIELD
AZ
01
—
520126
UNITED CONCORDIA
—
Enumeration date
11/01/2006
Last updated
07/08/2007
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