Moore, John Walter
Moore, John Walter is an individual health care provider with primary practice located at 2010 N Roosevelt Ave , Burlington IA 52601-2340. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Moore, John Walter can be contacted via phone (319) 753-6265.Contact Information
Primary practice address
2010 N Roosevelt Ave
Burlington IA 52601-2340
Phone: (319) 753-6265
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 7326 | Iowa |
Profile Details
| NPI number | 1720075757 |
|---|---|
| LBN Legal business name | Moore, John Walter |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720075757 | NPPES |
| Iowa | MEDICAID | 0049189 |
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