Organization
DOUGLAS W MOORE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS W MOORE DDS (PRESIDENT OWNER)
(641) 673-9411
Entity
Organization
Contact information
Practice address
1011 A AVE W, OSKALOOSA, IA 52577
(641) 673-9411
(641) 673-8109
Mailing address
1011 A AVE W, OSKALOOSA, IA 52577
(641) 673-9411
(641) 673-8109
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07236
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1052324
—
IA
Enumeration date
12/12/2006
Last updated
03/05/2012
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