Individual
BRIGHAM R MOORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
400 GALLERIA PKWY SE, SUITE 800, ATLANTA, GA 30339-5980
(770) 916-5028
(678) 302-7485
Mailing address
1719 BARNESDALE WAY NE, ATLANTA, GA 30309-2601
(404) 879-0176
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401411240
VA
1223G0001X
General Practice Dentistry
048628-1
NY
1223G0001X
General Practice Dentistry
12010805A
IN
1223G0001X
General Practice Dentistry
21505
MA
1223G0001X
General Practice Dentistry
37456
CA
1223G0001X
General Practice Dentistry
7025
AZ
1223G0001X
General Practice Dentistry
Primary
DN01856
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205516
—
MA
05
—
9180712
—
VA
Enumeration date
09/07/2006
Last updated
07/08/2007
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