Individual
MRS. STACIE M MOORE-MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
27 TURKEY CRK, LANGLEY, KY 41645-6403
(606) 285-9444
(606) 285-9449
Mailing address
27 TURKEY CRK, LANGLEY, KY 41645-6403
(606) 285-9444
(606) 285-9449
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7729
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6001740
—
KY
Enumeration date
09/01/2005
Last updated
03/03/2015
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