# MOORE FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568145795
- **Authorized official:** DR. LOREN P ISRAELSEN (OWNER)
- **Authorized official phone:** (361) 405-9080

## Contact information

- **Practice address:** 3001 S TELEPHONE RD, MOORE, OK 73160-2942
- **Practice address phone:** (405) 206-8090
- **Mailing address:** 5700 SE 89TH ST, OKLAHOMA CITY, OK 73135-6017
- **Mailing address phone:** (405) 206-8090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/14/2023
- **Last updated:** 08/14/2023