Individual
DR. ALISA O MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2440 FAIRBURN RD SW, SUITE 301, ATLANTA, GA 30331-5256
(404) 349-7777
(404) 349-8459
Mailing address
PO BOX 310065, ATLANTA, GA 31131-0065
(404) 349-7777
(404) 349-8459
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10731
GA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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