Individual
DR. JASON MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
8963 RACE TRACK RD, TAMPA, FL 33635-9724
(813) 818-8054
(813) 818-9683
Mailing address
19320 SEACOVE DR, LUTZ, FL 33558-9745
(813) 949-7409
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16030
FL
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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