Organization
MOORE DENTAL SERVICES, INC
Active
Other names
DENTAL DEVELOPMENT CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN JOSEPH MOORE (PRES)
(859) 371-4422
Entity
Organization
Contact information
Practice address
59 CAVALIER BLVD, 300, FLORENCE, KY 41042
(859) 525-0507
(859) 525-0610
Mailing address
59 CAVALIER BLVD, 300, FLORENCE, KY 41042
(859) 525-0507
(859) 525-0610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225306483
—
KY
Enumeration date
03/09/2007
Last updated
01/19/2021
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