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Organization
MOORE DENTAL SERVICES, INC
Active
Organization
MOORE DENTAL SERVICES, INC
Active
Other names
DENTAL DEVELOPMENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN JOSEPH MOORE (PRES)
(859) 371-4422
Entity
Organization
Contact information
Practice address
59 CAVALIER BLVD, 300, FLORENCE, KY 41042
(859) 525-0507
(859) 525-0610
Mailing address
59 CAVALIER BLVD, 300, FLORENCE, KY 41042
(859) 525-0507
(859) 525-0610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225306483
—
KY
Enumeration date
03/09/2007
Last updated
01/19/2021
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