| NPI | 1487379012 |
|---|---|
| Former Legal Business Name | STILLMAN & MOORE DENTAL PC |
| Entity Type | Organization |
| Authorized Contact | TERRANCE HENRY MOORE Owner/President 248-872-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |