Richard T. Moon, D.d.s., P.c.

NPI #1093931784 in Peoria, Illinois

Provider Information

NPI Number: 1093931784
Entity Type: Organization
Organization Name: Richard T. Moon, D.d.s., P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 18, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 6712 N MOUNTELLO DR
City: Peoria
State: Illinois
ZIP Code: 61614-2328
Phone: (309) 691-7855

Authorized Official

Name: DR. RICHARD THOMAS MOON, D.D.S.
Title: DENTIST
Phone: (309) 691-7855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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