# DRS. MOORE AND MOORE DENTAL ASSOCIATES

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

## Provider details

- **NPI number:** 1609973825
- **Authorized official:** DR. JOHN T MOORE D.D.S. (GENERAL DENTIST)
- **Authorized official phone:** (304) 343-7121

## Contact information

- **Practice address:** 420 VIRGINIA ST W, CHARLESTON, WV 25302-2008
- **Practice address phone:** (304) 343-7121
- **Practice address fax:** (304) 343-3323
- **Mailing address:** 420 VIRGINIA ST W, CHARLESTON, WV 25302-2008
- **Mailing address phone:** (304) 343-7121
- **Mailing address fax:** (304) 343-3323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2902 | WV | Yes |
| 1223G0001X | General Practice Dentistry | 2921 | WV | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0133287000 | — | WV |
| 05 | — | 0133320000 | — | WV |