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Provider Information for 1417098674

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

RONALD MOORE DDS

Gender: MALE

Individual NPI: 1417098674

Calendar   Last Updated:  2019-07-29
  Certification Date: 

Details

Name Value
NPI 1417098674
Enumeration Date 2007-02-09
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 25835 BARTON RD STE 104
LOMA LINDA, CA 92354-3898
United States

Phone: 909-796-2299 | Fax:
View Map External Link
Primary Practice Address 25835 BARTON RD STE 104
LOMA LINDA, CA 92354
United States

Phone: 909-796-2299 | Fax:
View Map External Link
Secondary Practice Address 25835 BARTON RD STE 104
LOMA LINDA, CA 92354-3898
United States

Phone: 909-796-2299 | Fax:
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 38096