Thomas Ryan Moss DDS

NPI 1013026624 - Dentist - 122300000X

NPI Details
NPI 1013026624
Gender Male
Enumeration Date 08/29/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1415 E STATE STREET
ROCKFORD IL, 61104, US
Phone (815) 964-5121
Fax (815) 964-6105
Business Location
1415 E STATE STREET
ROCKFORD IL, 61104, US
Phone (815) 964-5121
Fax (815) 964-6105
Toxanomy
Taxonomy Code 122300000X
License State Illinois
License Number 19A14367
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According to our database, Dr. Thomas Ryan Moss DDS NPI is 1013026624, taxonomy code is 122300000X and license number is 19A14367, license state is located at Illinois. Thomas Ryan Moss DDS physically located at 1415 E State Street, Rockford IL, 61104. NPI Number Thomas Ryan Moss DDS has the Individual type.

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1013026624 NPI number is provided on an as is basis without warranty of any kind. 1013026624 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Ryan Moss DDS are for informational purposes only.