Shirley Moore
Individual provider Active NPI Dental Hygienist · Alger, MI
NPI 1275924144 · NPPES record last updated Feb 12, 2015
Key facts
- NPI
- 1275924144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 2902016066 (MI)
- Practice address
- 5095 Rifle River TRL
Alger, MI 48610-9327 - Phone
- (989) 873-5152
- Fax
- (989) 873-5913
- NPI assigned
- Feb 12, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 2902016066 | MI | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902016066 | MI | Yes |
Addresses
Primary practice location
5095 Rifle River TRL
Alger, MI 48610-9327
Mailing address
241 E Andrews Rd
Au Gres, MI 48703-9682
Phone (989) 876-4040
Other providers in Alger, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2015. 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.