| NPI | 1336289040 |
|---|---|
| Other Name | SAMUEL JEFFERSON MOORE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 274293) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AL D.007162-C) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-02-27 |