Individual
MEGHAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
502 W RANDALL ST, COOPERSVILLE, MI 49404-1341
(616) 384-4129
Mailing address
402 COLLEGE AVE SE UNIT 2, GRAND RAPIDS, MI 49503-5302
(248) 872-6619
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600116
MI
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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