James T Moore, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Bridgeton, MO

NPI

1477683266

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

11925 (MO)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-03-07

Last updated

2007-07-08