Individual
RICHARD WALLACE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10220 SW GREENBURG ROAD, SUITE 150, TIGARD, OR 97223-5529
(503) 255-1200
(503) 408-6856
Mailing address
10220 SW GREENBURG ROAD, SUITE 150, TIGARD, OR 97223-5529
(503) 255-1200
(503) 408-6856
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5689
OR
Other
Enumeration date
01/05/2007
Last updated
12/19/2011
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