Individual
DR. BRENT WILLIAM MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
764 W COMMERCE ST, FAIRFIELD, TX 75840-1428
(903) 389-4151
Mailing address
764 W COMMERCE ST, FAIRFIELD, TX 75840-1428
(903) 389-4151
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16589
TX
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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