| NPI | 1205810686 |
|---|---|
| Former Name | VENITA C FREEMAN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013443) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ 6231) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2013-07-02 |