Individual
DR. CHARLES ANDREW MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5462 MEMORIAL DR, STONE MOUNTAIN, GA 30083-3239
(404) 299-0022
Mailing address
5390 FONTENOY CT, NORCROSS, GA 30071-4700
(770) 840-9889
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN008787
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00677311A
—
GA
Enumeration date
11/15/2006
Last updated
10/27/2008
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