DR. Kelly James Moore, DDS

NPI #1396847216 in Rockford, Illinois

Provider Information

NPI Number
1396847216
Entity Type
Individual
Name
DR. Kelly James Moore, DDS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DDS
Enumeration Date
Sep 1, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
6075 VANTAGE PL
ZIP Code
61107-5905
Phone
(815) 399-9040

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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