NPI 1063761773

Thomas F. Mooney, III, DDS, Mds, LLC

Organisation Dental Clinic/Center O Fallon, MO

Practice location

Address: 9018 Phoenix Pkwy, O Fallon, MO 63368-4278
Phone: (636) 970-4700

Authorised official

Name: Thomas F. Mooney
Title: Member / Manager
Phone: (636) 970-4700

Registered specialties

Dental Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QD0000X Licence 015486 (MO)

Other Clinic/Center providers in Missouri →

Registry record

NPI: 1063761773
Entity type: Organization
NPI issued: 10 Sep 2012
Record last updated: 10 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.