Moore, John Gregory
Moore, John Gregory is an sole proprietor health care provider with primary practice located at 1160 Johnson Ave Suite 104, Bridgeport WV 26330-1487. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Moore, John Gregory can be contacted via phone (304) 842-2361.Contact Information
Primary practice address
1160 Johnson Ave Suite 104
Bridgeport WV 26330-1487
Phone: (304) 842-2361
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2794 | West Virginia |
Profile Details
| NPI number | 1720165954 |
|---|---|
| LBN Legal business name | Moore, John Gregory |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1720165954 | NPPES |
| West Virginia | MEDICAID | 0137163000 | |
| West Virginia | Other | 94661 |
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