# MOORE DENTAL SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DENTAL DEVELOPMENT CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205968120
- **Authorized official:** MARTIN JOSEPH MOORE (PRES)
- **Authorized official phone:** (859) 371-4422

## Contact information

- **Practice address:** 59 CAVALIER BLVD, 300, FLORENCE, KY 41042
- **Practice address phone:** (859) 525-0507
- **Practice address fax:** (859) 525-0610
- **Mailing address:** 59 CAVALIER BLVD, 300, FLORENCE, KY 41042
- **Mailing address phone:** (859) 525-0507
- **Mailing address fax:** (859) 525-0610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |

## Other

- **Enumeration date:** 03/09/2007
- **Last updated:** 01/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1225306483 | — | KY |