DR. Hazel E Moore, DDS

NPI #1114914066 in Kenosha, Wisconsin

Provider Information

NPI Number: 1114914066
Entity Type: Individual
Name: DR. Hazel E Moore, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Oct 4, 2005
Last Updated: Dec 29, 2011

Practice Location

Address: 4536 22ND AVE
City: Kenosha
State: Wisconsin
ZIP Code: 53140-5917
Phone: (262) 656-0044

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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