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Organization
DR. KERRY MOON, D.D.S., PLLC
Active
Organization
DR. KERRY MOON, D.D.S., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERY MOON DDS (OWNER DENTIST)
(501) 281-5347
Entity
Organization
Contact information
Practice address
2501 CRESTWOOD RD STE 201, NORTH LITTLE ROCK, AR 72116-7616
(501) 758-5006
Mailing address
719 WILLOW ST, NORTH LITTLE ROCK, AR 72114-4637
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243554608
—
AR
Enumeration date
04/06/2022
Last updated
04/06/2022
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