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General NPI Number Information
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NPI Number | 1801790225
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Entity Type | Organization
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Legal Business Name | MOORE PEDIATRIC DENTAL, PLLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 1300 MAGNOLIA CT STE. C
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City | MOORE
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State | OK
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Zip | 73160-9999
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Country | US
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Telephone | 405-973-8443
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Fax |
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Provider Business Mailing Address
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Address Line | 537 NW 49TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-6601
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Country | US
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Telephone | 405-973-8443
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALISON AGEE
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Credential | DDS
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Telephone | 405-973-8443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State | NULL
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