Provider Demographics
NPI:1891808234
Name:MOORE, WILLIAM MURRAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MURRAY
Last Name:MOORE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 DALTON DR
Mailing Address - Street 2:STE B
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4463
Mailing Address - Country:US
Mailing Address - Phone:972-274-1312
Mailing Address - Fax:972-274-5222
Practice Address - Street 1:224 DALTON DR
Practice Address - Street 2:STE B
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4463
Practice Address - Country:US
Practice Address - Phone:972-274-1312
Practice Address - Fax:972-274-5222
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice