Individual
RAVEN SHANICE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
574 W SAM RIDLEY PKWY, SMYRNA, TN 37167-5621
(615) 488-1151
Mailing address
2521 OAK FOREST DR, ANTIOCH, TN 37013-1840
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12134
TN
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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