Individual
ALAN E MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
156 GRANVILLE ST, GAHANNA, OH 43230-6505
(614) 475-2616
Mailing address
156 GRANVILLE ST, GAHANNA, OH 43230-6505
(614) 475-2616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16776
OH
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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