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General NPI Number Information
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NPI Number | 1013930338
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Entity Type | Individual
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Provider Name | MARGARET GRAHAM MOORE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 900 PROFESSIONAL DR
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City | WARNER ROBINS
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State | GA
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Zip | 31088-0520
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Country | US
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Telephone | 478-333-3636
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Fax | 478-333-6399
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Provider Business Mailing Address
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Address Line | 223 OBERON LN
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City | MACON
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State | GA
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Zip | 31210-3097
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Country | US
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Telephone | 478-333-3636
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Fax | 478-333-6399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN012955
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License Number State | GA
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