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1407875891
LISA MARIE MOORE
SOUTH BEND, IN
NPI
1407875891
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: IN 12009706)
Enumeration Date
2006-07-18
Last Update Date
2007-07-09
Business Address
Dr. LISA MARIE MOORE DDS
1005 E LASALLE AVE
SOUTH BEND, IN 46617-2818
Phone number: 574-245-7501
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Mailing Address
Dr. LISA MARIE MOORE DDS
1005 E LASALLE AVE
SOUTH BEND, IN 46617-2818
Phone number: 574-245-7501
Copy
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