Moss, Richard Bradley
Moss, Richard Bradley is an sole proprietor health care provider with primary practice located at 1011 N Carroll Ave , Southlake TX 76092-5305. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Moss, Richard Bradley can be contacted via phone (817) 488-6513.Contact Information
Primary practice address
1011 N Carroll Ave
Southlake TX 76092-5305
Phone: (817) 488-6513
Fax: (817) 488-0487
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 16526 | Texas |
Profile Details
| NPI number | 1356439061 |
|---|---|
| LBN Legal business name | Moss, Richard Bradley |
| Credentials | DDS, PLLC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Mar 4th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356439061 | NPPES |
| Texas | Other | D16526 | BC/BS |
| Texas | Other | 731666 | BC/BS |
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