Moore, Walker B.
Moore, Walker B. is an individual health care provider with primary practice located at 4687 Rockbridge Rd Suite #7, Stone Mountain GA 30083-4258. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Moore, Walker B. can be contacted via phone (404) 296-9070.Contact Information
Primary practice address
4687 Rockbridge Rd Suite #7
Stone Mountain GA 30083-4258
Phone: (404) 296-9070
Fax: (404) 296-3456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | GA 7613 | Georgia |
Profile Details
| NPI number | 1376605196 |
|---|---|
| LBN Legal business name | Moore, Walker B. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2006 |
| Last updated | Apr 22nd, 2016 - about 10 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 | 1376605196 | NPPES |
| Georgia | MEDICAID | GA 7613 |
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