Moore, Carolyn
Moore, Carolyn is an sole proprietor health care provider with primary practice located at 257 Commerce Dr , Peachtree City GA 30269-1484. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Moore, Carolyn can be contacted via phone (770) 487-8896.Contact Information
Primary practice address
257 Commerce Dr
Peachtree City GA 30269-1484
Phone: (770) 487-8896
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 12708 | Georgia |
Profile Details
| NPI number | 1184781486 |
|---|---|
| LBN Legal business name | Moore, Carolyn |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184781486 | NPPES |
| Georgia | MEDICAID | 569840586A | |
| Georgia | MEDICAID | 569840586 |
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