Individual
DR. STEPHEN CHARLES MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
317 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 624-0636
(505) 625-2845
Mailing address
317 W COUNTRY CLUB RD, ROSWELL, NM 88201-5892
(505) 624-0636
(505) 625-2845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
NM 1360
NM
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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