# ANDREA MOORE DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Dental Office of Beaumont
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154805117
- **Authorized official:** ANDREA C MOORE DDS (OWNER DOCTOR)
- **Authorized official phone:** (951) 800-8095

## Contact information

- **Practice address:** 1620 E 1ST ST STE 200, BEAUMONT, CA 92223-3174
- **Practice address phone:** (951) 800-8095
- **Practice address fax:** (951) 800-8095
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 845-8890
- **Mailing address fax:** (302) 952-0892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 08/05/2022