Mark Moan, DMD

NPI #1992716252 in O Fallon, Missouri

Provider Information

NPI Number: 1992716252
Entity Type: Individual
Name: Mark Moan, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Aug 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1032 RONDALE CT
City: O Fallon
State: Missouri
ZIP Code: 63368-7368
Phone: (636) 949-2587

Specialties & Taxonomy Codes

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

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