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Individual

JOSEPH THOMAS MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2089 WOODRUFF RD, GREENVILLE, SC 29607-5940
(864) 297-6700
(864) 297-6012
Mailing address
2089 WOODRUFF RD, GREENVILLE, SC 29607-5940
(864) 297-6700
(864) 297-6012

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2373
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2373
LICENSE NUMBER
SC
Enumeration date
11/20/2006
Last updated
07/08/2007
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