Organization
PEDIATRIC AND ADOLESCENT DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOE MOMEN DDS (OWNER)
(304) 842-1921
Entity
Organization
Contact information
Practice address
9 CHENOWETH DR, BRIDGEPORT, WV 26330-1885
(304) 842-1921
(304) 842-1960
Mailing address
9 CHENOWETH DR, BRIDGEPORT, WV 26330-1885
(304) 842-1921
(304) 842-1960
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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