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Individual

DR. KENT E. MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., D.D.S.

Contact information

Practice address
2711 RANDOLPH RD, SUITE 510, CHARLOTTE, NC 28207-2034
(704) 358-8898
(704) 358-8889
Mailing address
2711 RANDOLPH RD, SUITE 510, CHARLOTTE, NC 28207-2034
(704) 358-8898
(704) 358-8889

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5366
NC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
5366
NC

Other

Enumeration date
07/10/2006
Last updated
07/19/2019
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