Individual
DR. FREDRIC A MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
514 W BANKHEAD HWY STE 600, VILLA RICA, GA 30180-1739
(770) 456-2550
Mailing address
514 W BANKHEAD HWY STE 600, VILLA RICA, GA 30180-1739
(770) 456-2550
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN010414
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366652174
NPI FOR FREDRIC A MOORE, DMD, PC (ORGANIZATION)
—
Enumeration date
01/23/2015
Last updated
01/23/2015
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