Individual
KIRK IRA MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
5750 W THUNDERBIRD RD, SUITE H-800, GLENDALE, AZ 85306-4660
(602) 978-2100
(602) 978-0708
Mailing address
5750 W THUNDERBIRD RD, SUITE H-800, GLENDALE, AZ 85306-4660
(602) 978-2100
(602) 978-0708
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3062
AZ
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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