Individual
JAY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 475-3800
(732) 483-6444
Mailing address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 475-3800
(732) 483-6444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02654700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2016
Last updated
11/30/2016
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