| NPI | 1104971282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL H MOORE Owner 915-585-8595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: TX 13265) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2008-12-10 |