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Individual
LORA B MOAK
Active
Individual
LORA B MOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN21270
FL
1223G0001X
General Practice Dentistry
Primary
4413
WV
Other
Enumeration date
06/12/2015
Last updated
11/30/2022
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