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Individual

LEE EUGENE MOORE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
106 S CUMMINGS LN, WASHINGTON, IL 61571-3442
(309) 444-2523
(309) 444-7223
Mailing address
106 S CUMMINGS LN, WASHINGTON, IL 61571-3442
(309) 444-2523
(309) 444-7223

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Enumeration date
09/08/2005
Last updated
07/08/2007
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