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General NPI Number Information
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NPI Number | 1669953618
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Entity Type | Organization
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Legal Business Name | ASHLEY GOMES-MOORE, DMD PLLC
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Dates
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Enumeration Date | 08/28/2018
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 755 GAR HWY
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City | SWANSEA
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State | MA
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Zip | 02777-4504
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Country | US
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Telephone | 508-496-0430
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Fax |
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Provider Business Mailing Address
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Address Line | 13 ROSELAND TER
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City | TIVERTON
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State | RI
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Zip | 02878-3507
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Country | US
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Telephone | 508-496-0430
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Fax |
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Authorized Official
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Title or Position | DMD/OWNER
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Name | ASHLEY GOMES-MOORE
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Credential |
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Telephone | 508-496-0430
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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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