Provider Demographics
NPI:1760507164
Name:DR. JAMES W. MOENTER, INC
Entity Type:Organization
Organization Name:DR. JAMES W. MOENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOENTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-312-1106
Mailing Address - Street 1:PO BOX 750426
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45475-0426
Mailing Address - Country:US
Mailing Address - Phone:937-312-1106
Mailing Address - Fax:
Practice Address - Street 1:8973 KINGSRIDGE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1623
Practice Address - Country:US
Practice Address - Phone:937-435-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3259 T1408152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty