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Individual

BEVERLY MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
5550 HEDGE LANE TER, SHAWNEE, KS 66226-2253
(913) 422-6699
Mailing address
1608 S GARFIELD ST, JUNCTION CITY, KS 66441-3966
(732) 754-1998

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60824
KS

Other

Enumeration date
06/19/2009
Last updated
02/27/2013
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