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General NPI Number Information
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NPI Number | 1356386098
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Entity Type | Organization
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Legal Business Name | H. G. MOORE, III & ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2702 MEDICAL OFFICE PL
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City | GOLDSBORO
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State | NC
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Zip | 27534-9460
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Country | US
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Telephone | 919-731-2331
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Fax | 919-731-2625
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Provider Business Mailing Address
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Address Line | PO BOX 1299
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City | GOLDSBORO
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State | NC
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Zip | 27533-1299
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Country | US
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Telephone | 919-731-2331
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Fax | 919-731-2625
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | ELLEN H. MOORE
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Credential |
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Telephone | 919-731-2331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1450
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License Number State | NC
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