DR. J Randall Moss, D.D.S.

NPI #1518026004 in Boise, Idaho

Provider Information

NPI Number: 1518026004
Entity Type: Individual
Name: DR. J Randall Moss, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Dec 8, 2006
Last Updated: Oct 1, 2009

Practice Location

Address: 8660 W EMERALD ST
Address 2: SUITE 152
City: Boise
State: Idaho
ZIP Code: 83704-4825
Phone: (208) 323-2294

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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