Stacy J. Moon Dds, Pa

LBN: Stacy J. Moon Dds, Pa
Stacy J. Moon Dds, Pa is an health care organization with primary practice located at 6019 N Eagle Rd , Boise ID 83713-0997. The organization recently has only one registered license in Ambulatory Health Care Facilities / Dental, which is considered as the primary health care specialty. Stacy J. Moon Dds, Pa can be contacted via phone (208) 939-7053, or through Moon, Stacy Jerald via phone (208) 939-7053.

Contact Information

Primary practice address
6019 N Eagle Rd Boise ID 83713-0997
Phone: (208) 939-7053
Fax: (208) 938-6032
Website:
Map and Directions
Authorized official contact:
Name: Moon, Stacy Jerald Doctor of Dental Surgery (DDS)
Phone: (208) 939-7053

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X D3387 Idaho

Profile Details

NPI number 1851554737
LBN Legal business name Stacy J. Moon Dds, Pa
DBA Doing business as
Authorized official Moon, Stacy Jerald Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 9th, 2008
Last updated Jul 9th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers