Individual
STANLEY DREW MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6224 PORTSMOUTH BLVD, SUITE 100, PORTSMOUTH, VA 23701-1345
(757) 488-8884
Mailing address
6224 PORTSMOUTH BLVD, SUITE 100, PORTSMOUTH, VA 23701-1345
(757) 488-8884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401008413
VA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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