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General NPI Number Information
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NPI Number | 1184559569
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Entity Type | Individual
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Provider Name | LAMARA MOORE RDH
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Gender | Female
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Dates
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Enumeration Date | 06/16/2026
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Last Update Date | 06/16/2026
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Provider Practice Location Address
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Address Line | 1155 BLUEGRASS CT STE 5
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City | ALPHARETTA
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State | GA
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Zip | 30004-2489
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Country | US
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Telephone | 678-404-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 886 GA HIGHWAY 257
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City | COCHRAN
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State | GA
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Zip | 31014-3504
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Country | US
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Telephone | 478-279-1304
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH005556
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License Number State | GA
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