Individual
DR. RICHARD HUGH MOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
201 E 6TH ST, MORRIS, MN 56267-1212
(320) 589-2161
(320) 589-3149
Mailing address
PO BOX 566, MORRIS, MN 56267-0566
(320) 589-2161
(320) 589-3149
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8903
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02297097
—
MN
Enumeration date
09/20/2006
Last updated
07/09/2007
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