Individual
VICTORIA NAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
21352 SW MAKAH CT, TUALATIN, OR 97062-9309
(503) 691-8376
Mailing address
21352 SW MAKAH CT., TUALATIN, OR 97062
(503) 691-8376
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6430
OR
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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