Provider Demographics
NPI:1568581510
Name:MOORE, JULIE E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:E
Last Name:MOORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 N JOSEY LN
Mailing Address - Street 2:101
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4633
Mailing Address - Country:US
Mailing Address - Phone:972-939-1990
Mailing Address - Fax:972-939-1991
Practice Address - Street 1:4323 N JOSEY LN
Practice Address - Street 2:101
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4633
Practice Address - Country:US
Practice Address - Phone:972-939-1990
Practice Address - Fax:972-939-1991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX157461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice