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NPI Code Detail

MEDICARE: MRS. LACHELLE HENDLEY MOORE DMD

MEDICARE: MRS. LACHELLE HENDLEY MOORE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN19455FL
21223G0001XGeneral Practice Dentistry8665SC

General Provider Information

NPI Number : 1235427972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LACHELLE HENDLEY MOORE DMD
Provider Business Mailing Address
First Line : 209 LATITUDE LANE
Second Line :
City : CLOVER
State : SC
Zip : 29710
Country : US
Telephone Number : 803-619-4511
Fax Number : 803-619-4586
Provider Business Practice Location Address
First Line : 209 LATITUDE LANE
Second Line :
City : CLOVER
State : SC
Zip : 29710
Country : US
Telephone Number : 803-619-4511
Fax Number : 803-619-4586
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2011
Last Update Date : 12/03/2025

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Directions to “ MRS. LACHELLE HENDLEY MOORE DMD” Practice Location

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