Individual
DR. FREDERICK MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
643 MAIN ST, PALMETTO, GA 30268-1138
(770) 463-4644
Mailing address
294 GLENWOOD AVE SE, ATLANTA, GA 30312-3155
(706) 231-6584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013353
GA
Other
Enumeration date
04/26/2007
Last updated
01/04/2012
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