Organization
MOORE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARZATTA MOORE (PRESIDENT)
(586) 558-8004
Entity
Organization
Contact information
Practice address
511 W 8 MILE RD, DETROIT, MI 48203-1004
(313) 454-4800
Mailing address
27201 RYAN RD, WARREN, MI 48092-5127
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014832
MI
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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