Individual provider · Type 1 NPI

Kellie Lynn Moore

Oral and Maxillofacial Surgery (Dentist) · Chicago, IL

NPI number 1942705140 Active

Practice location

251 E Huron St
Chicago, IL 60611

Call (312) 926-2000 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry 1223G0001X019031614 (IL)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X019031614 (IL)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1942705140

Kellie Lynn Moore's National Provider Identifier is 1942705140, issued on Mar 28, 2018. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Chicago, IL. The record was last updated on Jun 22, 2021.