Individual
JULASTENE DYER-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
199 HIGHWAY 50, PECOS, NM 87552
(505) 757-6666
Mailing address
PO BOX 710, PECOS, NM 87552-0710
(505) 757-6666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD4171
NM
122300000X
Dentist
DEN10751
CO
1223G0001X
General Practice Dentistry
Primary
DD4171
NM
Other
Enumeration date
04/10/2011
Last updated
12/12/2019
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