Individual
MICHAEL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MBA
Contact information
Practice address
4830 N LITCHFIELD RD STE 101, LITCHFIELD PARK, AZ 85340-4300
(623) 547-2022
(623) 547-2522
Mailing address
2411 ANTLER POINT DR, HENDERSON, NV 89074-6257
(901) 834-4316
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8881
AZ
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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