Organization
MARK MOORE DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK PHILLIP MOORE DMD (PRESIDENT)
(770) 297-7888
Entity
Organization
Contact information
Practice address
2048 WINDWARD LN, GAINESVILLE, GA 30501-7418
(770) 297-7888
Mailing address
2048 WINDWARD LN, GAINESVILLE, GA 30501-7418
(770) 297-7888
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011706
GA
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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