Individual
DR. REGAN L MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40292-0001
(502) 852-5128
(502) 852-7163
Mailing address
501 S PRESTON ST, LOUISVILLE, KY 40292-0001
(502) 852-5128
(502) 852-7163
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5947
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6003670
—
KY
01
—
9179124
DORAL DENTAL
—
Enumeration date
02/02/2007
Last updated
07/08/2007
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