Individual
DANIELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPA
Contact information
Practice address
280 1ST ST, HOLLOMAN AFB, NM 88330-8273
(575) 572-2778
Mailing address
280 1ST ST, HOLLOMAN AFB, NM 88330-8273
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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