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Individual

ALEX MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD, MS

Contact information

Practice address
6050 BRYNWOOD DR STE 205, ROCKFORD, IL 61114-6579
(816) 201-5955
(815) 201-5956
Mailing address
6050 BRYNWOOD DR STE 205, ROCKFORD, IL 61114-6579
(815) 621-6060

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1001449-15
WI

Other

Enumeration date
06/12/2017
Last updated
06/26/2025
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