Krystal Heaton Moore, DDS
Dentist, General Practice in Fort Worth, TX. Individual provider (NPI-1).
NPI number1215664271
StatusActive
Last updated in NPPESAug 1, 2022
Details
- NPI
- 1215664271
- Entity type
- Individual (NPI-1)
- Name
- Krystal Heaton Moore
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 1, 2022
- Certification date
- Aug 1, 2022
- Last updated
- Aug 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 38753 | TX | Yes |
| 122300000X | Dentist | 38753 | TX |
Practice location
1818 8th AveFort Worth, TX 76110-1391
Phone 817-874-7430
Mailing address
2400 State Highway 121 Apt 302Euless, TX 76039-4062
Phone 817-874-7430
Other practice locations
220 E Seminary Dr Ste 100
Fort Worth, TX 76115-2653
Fort Worth, TX 76115-2653
Phone 817-874-7430
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