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1114914066
HAZEL E MOORE
KENOSHA, WI
NPI
1114914066
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WI 3267-015)
Enumeration Date
2005-10-04
Last Update Date
2011-12-29
Business Address
Dr. HAZEL E MOORE DDS
4536 22ND AVE
KENOSHA, WI 53140-5917
Phone number: 262-656-0044
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Mailing Address
Dr. HAZEL E MOORE DDS
5822 CHARLES ST
RACINE, WI 53402-1824
Phone number: 262-681-2085
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