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Individual
BRIAN MOONEY
Active
Individual
BRIAN MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61344131
WA
1223P0221X
Pediatric Dentistry
D00948
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
01/29/2016
Last updated
11/21/2022
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