# ROBERT MOON DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376883702
- **Authorized official:** ROBERT MOON DMD (DENTIST)
- **Authorized official phone:** (509) 750-5062

## Contact information

- **Practice address:** 309 E 2ND AVE, ELLENSBURG, WA 98926-3315
- **Practice address phone:** (509) 962-6172
- **Mailing address:** 309 E 2ND AVE, ELLENSBURG, WA 98926-3315
- **Mailing address phone:** (509) 962-6172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DE60158372 | WA | Yes |

## Other

- **Enumeration date:** 02/21/2013
- **Last updated:** 02/21/2013