Individual
AUDREY MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
7400 FANNIN ST, SUITE 780, HOUSTON, TX 77054-1920
(713) 790-1001
(713) 790-1012
Mailing address
7400 FANNIN ST, SUITE 780, HOUSTON, TX 77054-1920
(713) 790-1001
(713) 790-1012
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
28170
TX
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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