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General NPI Number Information
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NPI Number | 1700778735
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Entity Type | Individual
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Provider Name | SARA ELIZABETH MOORE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 26540 ACE AVE
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City | LEESBURG
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State | FL
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Zip | 34748-8279
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Country | US
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Telephone | 352-326-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 5333 MILL STREAM DR
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City | SAINT CLOUD
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State | FL
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Zip | 34771-8720
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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 |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN30785
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License Number State | FL
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