DR. ETHAN MOORE, DMD

Dentist - General Practice

Active Individual
NPI: 1710555115

Practice Address

430 BROAD ST
Columbia, MS 39429

Phone: (601) 736-7125

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes 4212-21 (MS)

Frequently Asked Questions

NPI 1710555115 is the National Provider Identifier for DR. ETHAN MOORE, DMD, a Dentist - General Practice provider located in Columbia, MS. This NPI was enumerated on June 14, 2021.
DR. ETHAN MOORE, DMD practices at 430 BROAD ST, Columbia, MS 39429.

Quick Facts

NPI
1710555115
Type
Individual
Enumerated
Jun 14, 2021
Last Updated
Jul 7, 2025

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