Individual provider · Type 1 NPI
Justine Sherylyn Moe, MD, DDS
Oral and Maxillofacial Surgery (Dentist) · Okemos, MI
NPI number
1104143833
Active
Practice location
4201 Okemos Rd
Okemos, MI 48864-3200
Fax (517) 349-5566
Other practice locations
- 4500 Cascade Rd SE Ste 208, Grand Rapids, MI 49546-3665 · (616) 977-5000
- 2240 S State Rd, Ionia, MI 48846-2149 · (616) 523-9000
- 5238 W St Joe Hwy Ste 2, Lansing, MI 48917-4085 · (517) 323-1000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgery Physician | 208600000X | 4301111526 (MI) |
| Dentist | 122300000X | 4301111526 (MI) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 4301111526 (MI) |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 4301111526 (MI) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
About NPI 1104143833
Justine Sherylyn Moe, MD, DDS's National Provider Identifier is 1104143833, issued on Apr 20, 2010. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Okemos, MI. The record was last updated on Aug 26, 2024.