Individual
DR. JACK LOWELL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 SUNRISE AVENUE, SUITE C, ROSEVILLE, CA 95661-4561
(916) 782-1209
(916) 782-1770
Mailing address
700 SUNRISE AVENUE, SUITE C, ROSEVILLE, CA 95661-4561
(916) 782-1209
(916) 782-1770
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17346
CA
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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