Organization
DR. WILLIAM B. MOORE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BENNETT MOORE D.D.S. (OWNER)
(641) 456-3352
Entity
Organization
Contact information
Practice address
27 N FEDERAL ST, HAMPTON, IA 50441-1933
(641) 456-3352
(641) 456-2720
Mailing address
PO BOX 416, HAMPTON, IA 50441-0416
(641) 456-3352
(641) 456-2720
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06306
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154872
—
IA
Enumeration date
05/14/2008
Last updated
05/14/2008
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