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General NPI Number Information
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NPI Number | 1821008178
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Entity Type | Organization
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Legal Business Name | DRS. BARTS & MOORE PA
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 1718 E 4TH ST SUITE 804
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City | CHARLOTTE
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State | NC
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Zip | 28204-3261
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Country | US
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Telephone | 704-358-8898
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Fax | 704-358-8889
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Provider Business Mailing Address
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Address Line | 1718 E 4TH ST SUITE 804
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City | CHARLOTTE
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State | NC
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Zip | 28204-3261
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Country | US
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Telephone | 704-358-8898
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Fax | 704-358-8889
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Authorized Official
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Title or Position | ORAL & MAXILLOFACIAL SURGEON
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Name | DR. KENT E MOORE
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Credential | DDS, MD
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Telephone | 704-358-8898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 5366
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License Number State | NC
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