Individual
DR. TIMOTHY CHARLES MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS,MSD
Contact information
Practice address
826 PARCHMENT DR SE, SUITE # 200, GRAND RAPIDS, MI 49546-2374
(616) 285-9509
(616) 285-8856
Mailing address
826 PARCHMENT DR SE, SUITE # 200, GRAND RAPIDS, MI 49546-2374
(616) 285-9509
(616) 285-8856
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
2901010163
MI
Other
Enumeration date
07/13/2006
Last updated
07/21/2022
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