Individual
DR. DONALD ARTHUR MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 21ST STREET, U S ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Mailing address
2441 21ST STREET, U S ARMY DENTAL ACTIVITY, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
016155
OH
1223G0001X
General Practice Dentistry
016155
OH
1223G0001X
General Practice Dentistry
2461
SC
1223G0001X
General Practice Dentistry
Primary
8344
TN
Other
Enumeration date
07/20/2006
Last updated
10/04/2012
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