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Individual
DR. DAVID DWIGHT MOORE JR.
Active
Individual
DR. DAVID DWIGHT MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
59684
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R394
RESIDENT PERMIT
MN
Enumeration date
05/07/2008
Last updated
09/03/2010
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