| Thomas H. Moore Dds Ltd | |
|
6075 Vantage Pl Rockford IL 61107-5905 | |
| (815) 399-0677 | |
| Not Available |
| Full Name | Thomas H. Moore Dds Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6075 Vantage Pl, Rockford, Illinois |
| Authorized Official Name and Position | Ryan Thomas Moore (PRESIDENT) |
| Authorized Official Contact | 8153990677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas H. Moore Dds Ltd 4298 Windswept Way Loves Park IL 61111-8654 Ph: (815) 636-6673 | Thomas H. Moore Dds Ltd 6075 Vantage Pl Rockford IL 61107-5905 Ph: (815) 399-0677 |
| NPI Number | 1639202914 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639202914 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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