Individual
WESLEY B MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5528 1ST AVE N, BIRMINGHAM, AL 35212-2445
(205) 592-2255
(205) 592-3352
Mailing address
5528 1ST AVE N, BIRMINGHAM, AL 35212-2445
(205) 592-2255
(205) 592-3352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5525
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938612
—
AL
05
—
009938613
—
AL
05
—
009938614
—
AL
05
—
009942020
—
AL
01
—
51539328
BCBSANNISTON
AL
01
—
51539329
BCBSHEFLIN
AL
01
—
51539350
BCBSTALLADEGA
AL
Enumeration date
03/12/2007
Last updated
10/11/2007
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