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Individual

DR. KRISTINE M MOSIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1701 N SENATE BLVD, ROOM 1204A, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
(317) 962-8281
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
12010577
IN
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
12010577
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000358075
ANTHEM BCBS
IN
05
200490890
IN
01
P00267322
RAILROAD MEDICARE
IN
01
P00816224
RAILROAD MEDICARE
IN
Enumeration date
06/06/2006
Last updated
12/18/2020
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