Individual provider · Type 1 NPI

Pamela D. Moon

Dental Therapist · Richfield, MN

NPI number 1972991552 Active

Practice location

6600 Lyndale Ave S, 132
Richfield, MN 55423-3380

Mailing address

6625 Lyndale Ave S, Suite 300
Richfield, MN 55423-2373

Specialties and licenses

TaxonomyCodeLicense
Dental Therapist Primary 125J00000XDT16 (MN)

Dental Therapist: A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therap…

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About NPI 1972991552

Pamela D. Moon's National Provider Identifier is 1972991552, issued on Jan 5, 2015. The primary taxonomy on file is Dental Therapist (125J00000X), and the practice location is in Richfield, MN. The record was last updated on Jan 5, 2015.