KELLIE LYNN MOORE

CHICAGO, IL
NPI1942705140
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL  019031614)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: IL  019031614)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-03-28
Last Update Date2021-06-22
Business Address
KELLIE LYNN MOORE
251 E HURON ST
CHICAGO, IL 60611
Phone number: 312-926-2000
Mailing Address
KELLIE LYNN MOORE
251 E HURON ST
CHICAGO, IL 60611-3055
Phone number: 312-926-2000