Individual
DR. MICHAEL THOMAS MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2606 CAUGHEY RD, ERIE, PA 16506-2148
(814) 833-4393
Mailing address
6050 RUHL RD, FAIRVIEW, PA 16415-2530
(814) 602-1005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042148
PA
Other
Enumeration date
06/02/2019
Last updated
06/02/2019
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