# OCEANA DENTAL CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164299772
- **Authorized official:** DR. MICHAEL B MOORE DDS (OWNER)
- **Authorized official phone:** (304) 890-3465

## Contact information

- **Practice address:** 1427 COOK PARKWAY, OCEANA, WV 24870-2487
- **Practice address phone:** (304) 682-6104
- **Practice address fax:** (304) 682-6157
- **Mailing address:** PO BOX 1438, OCEANA, WV 24870-1438
- **Mailing address phone:** (304) 682-6104
- **Mailing address fax:** (304) 682-6104

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/05/2023
- **Last updated:** 12/05/2023