Individual
LORA B MOAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
180 E 2ND AVE, WILLIAMSON, WV 25661-3602
(304) 236-5902
(304) 235-8559
Mailing address
PO BOX 2080, WILLIAMSON, WV 25661-2080
(606) 794-4201
(304) 235-8559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN21270
FL
1223G0001X
General Practice Dentistry
Primary
4413
WV
Other
Enumeration date
06/12/2015
Last updated
11/30/2022
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