Individual
WILLIAM A MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1700 BAKER AVE EAST, HAINES CITY, FL 33844-4325
(863) 419-3252
(863) 419-3497
Mailing address
1290 GOLFVIEW AVE, ATTN: ACCOUNTS RECEIVABLE, BARTOW, FL 33830-6740
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN7469
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN7469
LICENSE
—
Enumeration date
12/11/2006
Last updated
02/26/2013
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