# MOORE DENTAL AT LEWIS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104208594
- **Authorized official:** DR. CLIFFORD W MOORE D.D.S. (OWNER)
- **Authorized official phone:** (419) 603-0236

## Contact information

- **Practice address:** 6421 PULLMAN DR, LEWIS CENTER, OH 43035-7377
- **Practice address phone:** (740) 548-5100
- **Mailing address:** 6421 PULLMAN DR, LEWIS CENTER, OH 43035-7377
- **Mailing address phone:** (740) 548-5100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 30.023482 | OH | Yes |

## Other

- **Enumeration date:** 06/23/2015
- **Last updated:** 06/23/2015