Individual
DR. JACK FRANK MOORES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
42051 MOUND RD, STERLING HEIGHTS, MI 48314-3143
(586) 323-7700
(586) 323-7707
Mailing address
42051 MOUND RD, STERLING HEIGHTS, MI 48314-3143
(586) 323-7700
(586) 323-7707
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901016423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3111522
—
MI
Enumeration date
10/17/2006
Last updated
07/08/2007
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