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Individual

DR. EVAN STOUT MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
201 N DALTON ST, MADISON, NC 27025-1903
(336) 548-9678
Mailing address
19810 W CATAWBA AVE STE A1, CORNELIUS, NC 28031-4056

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11410
NC

Other

Enumeration date
05/31/2019
Last updated
09/18/2024
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