Individual
DR. ETHAN TRENT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2201 QUEENS CHAPEL RD, HYATTSVILLE, MD 20782-3672
(301) 779-2744
Mailing address
2300 WASHINGTON PL NE APT 102, WASHINGTON, DC 20018-1054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18868
MD
1223G0001X
General Practice Dentistry
Primary
8134
NE
Other
Enumeration date
06/30/2025
Last updated
07/31/2026
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