Organization
DENNIS R. MOONEY DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEIGH E ANNAND (OFFICE MANAGER)
(850) 926-7151
Entity
Organization
Contact information
Practice address
215 OCHLOCKONEE ST, CRAWFORDVILLE, FL 32327-8022
(850) 926-7151
(850) 926-6116
Mailing address
215 OCHLOCKONEE ST, CRAWFORDVILLE, FL 32327-8022
(850) 926-7151
(850) 926-6116
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN0006229
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074033100
—
FL
01
—
141
PRO. # - MCNA
FL
01
—
42086
PRO. # - ADI, INC.
—
01
—
580933
PRO. # - COMPBENEFITS COR
—
01
—
65978
PRO. # - METLIFE
—
01
—
85439
PRO. # - BCBS
FL
Enumeration date
07/20/2006
Last updated
09/10/2012
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