Individual
DR. MICHAEL MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2611 W BROADWAY AVE, SULPHUR, OK 73086-6518
(580) 622-6655
Mailing address
2222 CLOVERLEAF PL, ARDMORE, OK 73401-3421
(214) 713-9759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7615
OK
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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