| Beverly Moon Dmd Llc | |
|
4601 W 109th St Ste 240 Overland Park KS 66211-1323 | |
| (913) 338-3384 | |
| Not Available |
| Full Name | Beverly Moon Dmd Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4601 W 109th St Ste 240, Overland Park, Kansas |
| Authorized Official Name and Position | Beverly Moon (DENTIST) |
| Authorized Official Contact | 7327541998 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Moon Dmd Llc 16424 Lucille St Overland Park KS 66221-7032 Ph: (732) 754-1998 | Beverly Moon Dmd Llc 4601 W 109th St Ste 240 Overland Park KS 66211-1323 Ph: (913) 338-3384 |
| NPI Number | 1962037523 |
|---|---|
| Provider Enumeration Date | 03/04/2020 |
| Last Update Date | 03/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962037523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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