| Amanda Claire Moberly, DMD | |
|
104 Legacy Dr, Berea, KY 40403-9594 | |
| (859) 986-2323 | |
| Not Available |
| Full Name | Amanda Claire Moberly |
|---|---|
| Gender | Female |
| Speciality | Dentist |
| Location | 104 Legacy Dr, Berea, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003650862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D-00144 (Kentucky) | Primary |
| Entity Name | Healthsource Of Ohio, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275966863 PECOS PAC ID: 2264328749 Enrollment ID: O20140521002611 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Claire Moberly, DMD 401 Highland Park Dr, Richmond, KY 40475-3839 Ph: (859) 626-7700 | Amanda Claire Moberly, DMD 104 Legacy Dr, Berea, KY 40403-9594 Ph: (859) 986-2323 |
Dr. Melissa Jane Jones, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 201 Pauline Dr, Suite H, Berea, KY 40403 Phone: 859-985-0201 | |
Dr. Eric Stefan Jacobson, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 1006 Ace Dr, Berea, KY 40403 Phone: 859-286-6999 Fax: 859-406-1333 | |
Dr. Alex Keith Noble, D.M.D Dentist Medicare: Not Enrolled in Medicare Practice Location: 103 Fee St, Berea, KY 40403 Phone: 502-409-1414 | |
Emily Louise Jones, Dentist Medicare: Medicare Enrolled Practice Location: 104 Legacy Dr, Berea, KY 40403 Phone: 859-986-2323 Fax: 859-986-7728 | |
Dr. Charles Edward Brents, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 103 Fee St, Berea, KY 40403 Phone: 859-986-3346 Fax: 859-986-4530 | |
Dr. Mary E Oldfield, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 126 N Broadway St, Berea, KY 40403 Phone: 859-986-2060 Fax: 859-986-4978 |