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Organization
MOON DENTAL LLC
Active
Organization
MOON DENTAL LLC
Active
Other names
Cornerstone Dental Health
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA-ROCHA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
334 S 8TH ST, QUINCY, IL 62301-4106
(217) 222-4525
Mailing address
334 S 8TH ST, QUINCY, IL 62301-4106
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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