Organization
DANIEL J MOORE DDS A PROFESSIONAL DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL J MOORE DDS (DOCTOR DENTIST)
(318) 371-2211
Entity
Organization
Contact information
Practice address
1117 HOMER ROAD, MINDEN, LA 71058
(318) 371-2211
Mailing address
PO BOX 310, 1117 HOMER ROAD, MINDEN, LA 71058
(318) 371-2211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3860
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1838608
—
LA
Enumeration date
01/17/2007
Last updated
02/06/2013
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