Individual
DR. GERALD RODGER MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2809 W WILLOW KNOLLS RD, G RODGER MOON DDS, PEORIA, IL 61614
(309) 682-2090
(309) 682-0903
Mailing address
2809 W WILLOW KNOLLS RD, G RODGER MOON DDS, PEORIA, IL 61614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19A13409
IL
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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