Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KELLY RAE MOORE, DDS
ActiveDR. KELLY RAE MOORE, DDS is a Dentist healthcare provider located in MOUND, Minnesota. NPI 1790277416 is currently active in the NPPES registry. Verify at CMS.
Dentist · MOUND, MN
Registration Details
- NPI Number
- 1790277416
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 30, 2018 (8.2063904158909 yrs)
- Last Updated
- Apr 10, 2025
- License
-
D14010 (MN)
Practice Information
- Address
-
5205 SHORELINE DRMOUND, MN, 553641770Browse MN providers · Browse ZIP 55364
- Phone
- 9528312800
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in MOUND, MN
| Name | Credential | NPI |
|---|---|---|
| DR. ROBERT A LAUER | DDS | 1205913282 |
| DR. MARY BERNADETTE PHILP | DDS | 1538447644 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.