Organization
TIMOTHY C. MOORE, DDS, MSD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY CHARLES MOORE DDS, MSD (PRESIDENT)
(616) 285-9509
Entity
Organization
Contact information
Practice address
826 PARCHMENT DR SE, SUITE # 200, GRAND RAPIDS, MI 49546-2374
(616) 285-9509
(616) 285-8856
Mailing address
826 PARCHMENT DR SE, SUITE # 200, GRAND RAPIDS, MI 49546-2374
(616) 285-9509
(616) 285-8865
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
2901010163
MI
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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