Moreno, Carol Lynn
Moreno, Carol Lynn is an sole proprietor health care provider with primary practice located at 1205 N Columbus St , West Liberty IA 52776-9601. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Moreno, Carol Lynn can be contacted via phone (319) 627-2612.Contact Information
Primary practice address
1205 N Columbus St
West Liberty IA 52776-9601
Phone: (319) 627-2612
Fax: (319) 627-2178
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 6899 | Iowa |
Profile Details
| NPI number | 1174635221 |
|---|---|
| LBN Legal business name | Moreno, Carol Lynn |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Sep 11th, 2012 - about 12 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 | 1174635221 | NPPES |
| Iowa | MEDICAID | 1216853 |
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