Moon, Gerald Rodger

Moon, Gerald Rodger is an individual health care provider with primary practice located at 2809 W Willow Knolls Rd G Rodger Moon Dds, Peoria IL 61614. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Moon, Gerald Rodger can be contacted via phone (309) 682-2090.

Contact Information

Primary practice address
2809 W Willow Knolls Rd G Rodger Moon Dds Peoria IL 61614
Phone: (309) 682-2090
Fax: (309) 682-0903
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 19A13409 Illinois

Profile Details

NPI number 1669516688
LBN Legal business name Moon, Gerald Rodger
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2007
Last updated Jul 8th, 2007 - about 19 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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