Organization
DRS. MOORE AND MOORE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T MOORE D.D.S. (GENERAL DENTIST)
(304) 343-7121
Entity
Organization
Contact information
Practice address
420 VIRGINIA ST W, CHARLESTON, WV 25302-2008
(304) 343-7121
(304) 343-3323
Mailing address
420 VIRGINIA ST W, CHARLESTON, WV 25302-2008
(304) 343-7121
(304) 343-3323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2902
WV
1223G0001X
General Practice Dentistry
2921
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133287000
—
WV
05
—
0133320000
—
WV
Enumeration date
09/20/2006
Last updated
08/22/2020
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