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General NPI Number Information
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NPI Number | 1528457710
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Entity Type | Organization
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Legal Business Name | WILLIAM P.E. MOORE, DMD, LLC
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Dates
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Enumeration Date | 01/12/2015
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 500 N COLUMBIA RIVER HWY SUITE 505
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City | SAINT HELENS
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State | OR
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Zip | 97051-1299
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Country | US
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Telephone | 503-396-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 500 N COLUMBIA RIVER HWY SUITE 505
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City | SAINT HELENS
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State | OR
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Zip | 97051-1299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. WILLIAM MOORE
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Credential | D.M.D.
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Telephone | 503-396-4750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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