Organization
THOMAS H. MOORE DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN THOMAS MOORE D.D.S. (PRESIDENT)
(815) 399-0677
Entity
Organization
Contact information
Practice address
6075 VANTAGE PL, ROCKFORD, IL 61107-5905
(815) 399-0677
Mailing address
4298 WINDSWEPT WAY, LOVES PARK, IL 61111-8654
(815) 636-6673
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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