Shanan Mossman DDS Pllc

NPI #1407128291 in Mico, Texas

Provider Information

NPI Number: 1407128291
Entity Type: Organization
Organization Name: Shanan Mossman DDS Pllc
Primary Specialty: Dentist
Enumeration Date: Feb 8, 2012
Last Updated: Feb 8, 2012

Practice Location

Address: 137 PR 1735
City: Mico
State: Texas
ZIP Code: 78056-5539
Phone: (210) 859-6261

Authorized Official

Name: DR. SHANAN M MOSSMAN, DDS
Title: DENTIST/OWNER
Phone: (210) 859-6261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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