Individual
PAUL T MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
306 SOUTH SHADY AVE., DAMASCUS, VA 24236
(276) 475-5116
(276) 475-5665
Mailing address
306 SOUTH SHADY AVE., DAMASCUS, VA 24236
(276) 475-5116
(276) 475-5665
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008807
VA
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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