Individual
DR. JOHN WESLEY MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-7374
(608) 782-4111
Mailing address
1200 MAIN ST, LA CROSSE, WI 54601-4102
(608) 782-7374
(608) 782-4111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5473-015
WI
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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