# MOORE DENTISTRY, INC.

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

## Provider details

- **NPI number:** 1922270404
- **Authorized official:** DR. BRENT ALLEN MOORE D.D.S. (PRESIDENT)
- **Authorized official phone:** (317) 348-1354

## Contact information

- **Practice address:** 11630 OLIO RD, SUITE \#100, FISHERS, IN 46037-7677
- **Practice address phone:** (317) 348-1354
- **Practice address fax:** (866) 511-4151
- **Mailing address:** 14575 LANSING PL, FISHERS, IN 46038-5273
- **Mailing address phone:** (317) 679-8207
- **Mailing address fax:** (866) 511-4151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12010751A | IN | Yes |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 03/25/2008