| NPI | 1558943308 |
|---|---|
| Doing Business As | MOONLIGHT DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SORA MOON Dentist 310-425-4508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2021-05-12 |