Moore, Shane L
Moore, Shane L is an individual health care provider with primary practice located at 2455 W Interstate 40 , Amarillo TX 79109-1852. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Moore, Shane L can be contacted via phone (806) 350-5437.Contact Information
Primary practice address
2455 W Interstate 40
Amarillo TX 79109-1852
Phone: (806) 350-5437
Fax: (806) 350-5438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 18661 | Texas |
Profile Details
| NPI number | 1538233622 |
|---|---|
| LBN Legal business name | Moore, Shane L |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| 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 | 1538233622 | NPPES |
| Texas | Other | 1420292 | UNITED CONCORDIA |
| Texas | Other | 89D745 | UNITED CONCORDIA |
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