Provider Demographics
NPI:1548674468
Name:MOSLEY, LABREIA (DDS)
Entity type:Individual
Prefix:
First Name:LABREIA
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16222 STUEBNER AIRLINE RD APT 709
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7329
Mailing Address - Country:US
Mailing Address - Phone:832-713-0384
Mailing Address - Fax:
Practice Address - Street 1:16222 STUEBNER AIRLINE RD APT 709
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7329
Practice Address - Country:US
Practice Address - Phone:832-713-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist