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Individual

DR. MARTIN JOSEPH MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
6961 BURLINGTON PIKE, FLORENCE, KY 41042
(859) 371-4422
(859) 282-5482
Mailing address
6961 BURLINGTON PIKE, FLORENCE, KY 41042
(859) 371-4422
(859) 282-5482

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
6108
KY
1223P0221X
Pediatric Dentistry
Primary
6108
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60061082
KY
Enumeration date
12/02/2011
Last updated
03/04/2020
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