Individual
MICHAEL MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1595 PEACHTREE PKWY STE 207, CUMMING, GA 30041-9583
(177) 088-8828
Mailing address
9771 TALISMAN DR, ALPHARETTA, GA 30022-7163
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123174
GA
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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