| Timothy C. Moore, Dds, Msd, Pc | |
|
826 Parchment Dr Se Suite # 200 Grand Rapids MI 49546-2374 | |
| (616) 285-9509 | |
| (616) 285-8856 |
| Full Name | Timothy C. Moore, Dds, Msd, Pc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 826 Parchment Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Timothy Charles Moore (PRESIDENT) |
| Authorized Official Contact | 6162859509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy C. Moore, Dds, Msd, Pc 826 Parchment Dr Se Suite # 200 Grand Rapids MI 49546-2374 Ph: (616) 285-9509 | Timothy C. Moore, Dds, Msd, Pc 826 Parchment Dr Se Suite # 200 Grand Rapids MI 49546-2374 Ph: (616) 285-9509 |
| NPI Number | 1578759437 |
|---|---|
| Provider Enumeration Date | 09/24/2007 |
| Last Update Date | 09/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578759437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 2901010163 (Michigan) | Primary |
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