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Dr. Russell Ernest Moore, DMD
General Practice Dentistry in Johnstown, Pennsylvania
NPI 1578525184

Russell Ernest Moore is a General Practice Dentistry based in Johnstown, PA and is specialized in General Practice. Russell Ernest Moore practices in Johnstown, PA and has the professional credentials of DMD. The NPI Number for Russell Ernest Moore is 1578525184 and holds a License No. DS036489 (Pennsylvania).

The current practice location address for Russell Ernest Moore is 111 Industrial Park Rd, Johnstown, PA and can be reached out via phone at 814-266-3151 and via fax at 814-262-9702.

Location: 111 Industrial Park Rd, Johnstown, PA, 15904-1878
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578525184
Provider Name
Russell Ernest Moore
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
111 Industrial Park Rd, Johnstown, PA, 15904-1878
Phone Number
814-266-3151
Fax Number
814-262-9702
Provider Enumeration Date
04/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1746802 01 PA BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
111 Industrial Park Rd
City
Johnstown
State
Pennsylvania
Zip
15904-1940
Phone Number
814-266-3151
Fax Number
814-262-9702
person
Provider Business Mailing Address Details
Address
111 Industrial Park Rd
City
Johnstown
State
Pennsylvania
Zip
15904-1940
Phone Number
814-266-3151
Fax Number
814-262-9702
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DS036489 (Pennsylvania)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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