Provider Demographics
NPI:1578638342
Name:MOYER, MICHAEL GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GEORGE
Last Name:MOYER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE
Mailing Address - Street 2:CMR 475
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09036
Mailing Address - Country:US
Mailing Address - Phone:49931-889-7714
Mailing Address - Fax:49931-889-7718
Practice Address - Street 1:BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - Street 2:CMR 475
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09036
Practice Address - Country:US
Practice Address - Phone:49931-889-7714
Practice Address - Fax:49931-889-7718
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010080641223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics