IndividualActive
Timothy Moore, DDS,MSD
NPI 1679599930 · Prosthodontics · Grand Rapids, MI
Provider details
- NPI number
- 1679599930
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Credential
- DDS,MSD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2901010163 (MI)
Specialties & taxonomies
Dental Providers
Practice location
826 Parchment Dr Se
Suite # 200
Grand Rapids, MI 49546-2374
Phone: (616) 285-9509
Fax: (616) 285-8856
Approximate (ZIP-level) locationGet directions
Mailing address
826 Parchment Dr Se
Grand Rapids, MI 49546-2374
Registry dates
- Enumerated
- 2006-07-13
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.