Individual
PHILIP MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
28 HENHAWK RD, GREAT NECK, NY 11024-2040
(516) 589-1830
Mailing address
28 HENHAWK RD, GREAT NECK, NY 11024-2040
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
062521
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/26/2016
Last updated
03/13/2023
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