Individual
DR. JOHN MICHAEL MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M,D
Contact information
Practice address
2001 AUGUSTA HWY STE A, LEXINGTON, SC 29072-1927
(912) 748-8585
Mailing address
2001 AUGUSTA HIGHWAY UNIT A, LEXINGTON, SC 29072
(912) 748-8585
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6962
SC
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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