Individual
LAURA MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
520 SUMMIT AVE, HACKENSACK, NJ 07601-1550
(201) 488-9030
Mailing address
520 SUMMIT AVE, HACKENSACK, NJ 07601-1550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02596800
NJ
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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