| Andrew L Moore Jr Ms Pc | |
|
2063 Jefferson Davis Hwy Suite One Stafford VA 22554 | |
| (540) 659-7515 | |
| (540) 659-7515 |
| Full Name | Andrew L Moore Jr Ms Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2063 Jefferson Davis Hwy, Stafford, Virginia |
| Authorized Official Name and Position | Andrew Lewis Moore (OWNER) |
| Authorized Official Contact | 5406597515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew L Moore Jr Ms Pc Po Box 968 Stafford VA 22555 Ph: (540) 659-7515 | Andrew L Moore Jr Ms Pc 2063 Jefferson Davis Hwy Suite One Stafford VA 22554 Ph: (540) 659-7515 |
| NPI Number | 1538326517 |
|---|---|
| Provider Enumeration Date | 05/19/2008 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538326517 | NPI | - | NPPES |
| 686682 | Other | VA | CARENET |
| 104019 | Other | VA | UNITED CON TRICARE |
| 291871 | Other | VA | ANTHEM |
| 7804148 | Other | VA | SMILES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 041006050 (Virginia) | Primary |
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