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Individual

DR. KENT E MOSBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3671
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6J770
BLUE CROSS OF IDAHO
ID
Enumeration date
09/15/2006
Last updated
12/06/2011
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