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Individual

SEYED MOE MOMEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9 CHENOWETH DRIVE, BRIDGEPORT, WV 26330
(304) 842-1921
(604) 842-1960
Mailing address
9 CHENOWETH DRIVE, BRIDGEPORT, WV 26330
(304) 842-1921
(604) 842-1960

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3301
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0138589000
WV
Enumeration date
11/24/2006
Last updated
07/08/2007
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