Individual
JEFF MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6735 LEABERRY WAY, HAYMARKET, VA 20169
(703) 753-7077
Mailing address
6735 LEABERRY WAY, HAYMARKET, VA 20169
(703) 753-7077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412859
VA
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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