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Individual

DENISE MOORE-EBHOHIMEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
5256 ARMOUR RD, SUITE 1B, COLUMBUS, GA 31904-5037
(706) 653-7668
(706) 653-7669
Mailing address
5256 ARMOUR RD, SUITE 1B, COLUMBUS, GA 31904-5037
(706) 653-7668
(706) 653-7669

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12521
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0015637
ASSURANT
GA
05
00965313A
GA
01
01419459
UNITED CONCORDIA
GA
01
100674
AVESIS
GA
01
600-25826
BLUE CROSS BLUE SHIELD AL
GA
01
9181770
DORAL
GA
Enumeration date
10/17/2006
Last updated
07/08/2007
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