John Patrick Moore, D.D.S.
Individual provider Active NPI General Practice Dentistry · Shelby, MT
NPI 1083777684 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1083777684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1494 (MT)
- Practice address
- 865 Oilfield Ave
Shelby, MT 59474-2702 - Phone
- (406) 434-5146
- Fax
- (406) 434-5147
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1494 | MT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1494 | MT | Yes |
Addresses
Primary practice location
865 Oilfield Ave
Shelby, MT 59474-2702
Mailing address
865 Oilfield Ave
Shelby, MT 59474-2702
Phone (406) 434-5146
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139113 | Medicaid | MT |
Other providers in Shelby, MT
- Darcy Jo McAllister
- Mary Louise Meis
- Haley A Menge
- Brian Meyer
- Stephen G Milheim
- My Hearing Centers, LLC
- Northtown Drug LLC
- Northtown Drug LLC
- Open Skies Counseling LLC
- Alyson Raph
All providers in Shelby, MT · General Practice Dentistry in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.