Individual
DR. MARK TIMOTHY MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
806 W MAIN ST, JAMESTOWN, NC 27282-9508
(336) 454-1192
(336) 454-1193
Mailing address
806 W MAIN ST, JAMESTOWN, NC 27282-9508
(336) 454-1192
(336) 454-1193
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5616
NC
Other
Enumeration date
06/05/2009
Last updated
06/05/2009
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