Individual
JUSTINE SHERYLYN MOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, DDS
Contact information
Practice address
4201 OKEMOS RD, OKEMOS, MI 48864-3200
(517) 349-8383
(517) 349-5566
Mailing address
4201 OKEMOS RD, OKEMOS, MI 48864-3200
(517) 349-8383
(517) 349-5566
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4301111526
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4301111526
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4301111526
MI
208600000X
Surgery Physician
4301111526
MI
Other
Enumeration date
04/20/2010
Last updated
08/26/2024
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