Individual
DR. JOHN THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
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
2921
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133287000
—
WV
Enumeration date
04/11/2007
Last updated
07/08/2007
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