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Organization
GUY W. MOORMAN, JR. DDS. PC
Active
Organization
GUY W. MOORMAN, JR. DDS. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY LYNN SMITH (OFFICE MANAGER)
(912) 384-7400
Entity
Organization
Contact information
Practice address
1150 WARD STREET EXT W, DOUGLAS, GA 31533-1900
(912) 384-7400
Mailing address
1150 WARD STREET EXT W, DOUGLAS, GA 31533-1900
(912) 384-7400
(912) 384-7414
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN007456
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578698650
—
GA
Enumeration date
12/11/2015
Last updated
12/11/2015
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