Provider Demographics
NPI:1477155844
Name:JAMES R. MOORE D.D.S., J.CRAIG MOORE D.M.D., P.C.
Entity Type:Organization
Organization Name:JAMES R. MOORE D.D.S., J.CRAIG MOORE D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:814-266-3151
Mailing Address - Street 1:111 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-1940
Mailing Address - Country:US
Mailing Address - Phone:814-266-3151
Mailing Address - Fax:
Practice Address - Street 1:111 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1940
Practice Address - Country:US
Practice Address - Phone:814-266-3151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental