OrganizationMoeller, P.C.(<Unavail>)DentistDental ProvidersPractice Address2509 S State St, Ann Arbor, MI 48104-6145(734) 662-7874PECOS EnrollmentBased on the most recent information from CMS, provider Moeller, P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1568700540Provider TypeOrganizationFull NameMoeller, P.C.Other Name<Unavail>SubpartNoEnumeration Date1/24/2013Last Updated3/3/2013Contact InformationPractice LocationPractice Address2509 S State St, Ann Arbor, MI 48104-6145Phone(734) 662-7874FaxUnlisted FaxMailing LocationMailing Address2509 S State St, Ann Arbor, MI 48104-6145Phone(734) 662-7874FaxUnlisted FaxAuthorized OfficialNameMoeller, Mauricio Sergio (Owner)Phone(734) 222-0023Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense2901018235Michigan