Moon, Kristopher Joe

Moon, Kristopher Joe is an individual health care provider with primary practice located at 2803 Business Center Dr. Suite 121, Pearland TX 77584. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Moon, Kristopher Joe can be contacted via phone (713) 436-3444.

Contact Information

Primary practice address
2803 Business Center Dr. Suite 121 Pearland TX 77584
Fax: (713) 436-7442
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 20225 Texas
Dental Providers / General Practice 1223G0001X 20225 Texas

Profile Details

NPI number 1184724411
LBN Legal business name Moon, Kristopher Joe
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Aug 13th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184724411 NPPES
Texas MEDICAID 164702601

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