Individual
JOHN WALTER MOORE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2010 N ROOSEVELT AVE, BURLINGTON, IA 52601-2340
(319) 753-6265
Mailing address
2010 N ROOSEVELT AVE, BURLINGTON, IA 52601-2340
(319) 753-6265
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7326
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049189
—
IA
Enumeration date
10/04/2005
Last updated
07/08/2007
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