Individual
DR. DOD DAVID MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10104 SADDLE CREEK RD, WACO, TX 76708
(254) 836-9595
Mailing address
10104 SADDLE CREEK RD, WACO, TX 76708-7290
(254) 836-9595
(254) 836-0267
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G60270-01
DELTA DENTAL CHIPS
TX
Enumeration date
03/26/2007
Last updated
03/26/2013
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