Provider Demographics
NPI:1700622370
Name:MOORE, REBECCA BATTS (RDH)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:BATTS
Last Name:MOORE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12513 NC HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:HOLLY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28445-6535
Mailing Address - Country:US
Mailing Address - Phone:910-200-9316
Mailing Address - Fax:
Practice Address - Street 1:12513 NC HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-6535
Practice Address - Country:US
Practice Address - Phone:910-200-9316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4830124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist