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General NPI Number Information
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NPI Number | 1598066813
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Entity Type | Organization
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Legal Business Name | LINDSAY H. MOORE, DMD PA
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 3535 COUNTY LINE RD
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City | ANDREWS
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State | SC
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Zip | 29510-8111
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Country | US
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Telephone | 843-221-4746
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Fax | 843-221-4750
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Provider Business Mailing Address
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Address Line | 3535 COUNTY LINE RD
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City | ANDREWS
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State | SC
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Zip | 29510-8111
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Country | US
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Telephone | 843-221-4746
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Fax | 843-221-4750
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. LINDSAY H MOORE
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Credential | DMD
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Telephone | 843-221-4746
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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 | 4116
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License Number State | SC
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