Individual
KATHLEEN M MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
300 AVON AVE S, SUITE F, AVON, MN 56310-8516
(320) 356-7374
(320) 356-9427
Mailing address
PO BOX 181, AVON, MN 56310-0181
(320) 356-7374
(320) 356-9427
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10962
MN
Other
Enumeration date
10/26/2005
Last updated
11/26/2007
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