Individual
DR. DAVID DWIGHT MOORE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
235 N SAN MATEO DR, SUITE 400, SAN MATEO, CA 94401-2621
(650) 340-0225
Mailing address
235 N SAN MATEO DR, SUITE 400, SAN MATEO, CA 94401-2621
(650) 340-0225
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
59684
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R394
RESIDENT PERMIT
MN
Enumeration date
05/07/2008
Last updated
09/03/2010
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