Individual
KERRY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 W PERSHING BLVD, NORTH LITTLE ROCK, AR 72114-2148
(501) 753-2800
Mailing address
719 WILLOW ST, NORTH LITTLE ROCK, AR 72114-4637
(501) 281-5347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4453
AR
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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