Individual
BRETT MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1647 TAUSSIG BOULEVARD, NORFOLK, VA 23511-2830
(757) 952-8606
Mailing address
1647 TAUSSIG BOULEVARD, NORFOLK, VA 23511-2830
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12784
MN
Other
Enumeration date
06/29/2010
Last updated
07/29/2010
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