Organization
ASTOUNDING BRIGHT CONFIDENT SMILES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARZETTA MOORE DDS (PRESIDENT)
(248) 626-5222
Entity
Organization
Contact information
Practice address
5848 APPLEWOOD, 1404, WEST BLOOMFIELD, MI 48322-3488
(248) 626-5222
Mailing address
14411 W 8 MILE RD, DETROIT, MI 48235-1619
(248) 626-5222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014832
MI
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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