Individual
DR. GARY ANTHONY MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 ELEVENTH AVE, SUITE D-3, SHALIMAR, FL 32579
(850) 651-6700
(850) 609-0796
Mailing address
1 ELEVENTH AVE, SUITE D-3, SHALIMAR, FL 32579
(850) 651-6700
(850) 609-0796
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
8010253-9922
UT
1223G0001X
General Practice Dentistry
Primary
DN20806
FL
Other
Enumeration date
09/30/2011
Last updated
06/19/2015
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