Individual
PAMELA D MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 LYNDALE AVE S, 132, RICHFIELD, MN 55423-3380
(612) 243-8999
Mailing address
6625 LYNDALE AVE S, SUITE 300, RICHFIELD, MN 55423-2373
(612) 243-8999
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT16
MN
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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