Individual
DR. MARK WAYNE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2301 12TH ST, MERIDIAN, MS 39301-3934
(601) 483-1818
(601) 483-1117
Mailing address
2301 12TH ST, MERIDIAN, MS 39301-3934
(601) 483-1818
(601) 483-1117
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
ENDO-321
MS
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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