Search › Indiana › 122300000X
Shannon Moore, DMD MSED
NPI 1194855205 · on the registry since 2007
Practice
- Address
- 2815 N Walnut Street
Bloomington, IN 47404 - Phone
- (812) 332-1405
- Fax
- (812) 332-4331
- Organisation at this address
- Create-A-Smile, Pc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-03-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana