Provider Demographics
NPI:1528780608
Name:MOONEY AND HOLMBERG, DDS, PLLC
Entity type:Organization
Organization Name:MOONEY AND HOLMBERG, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-802-6042
Mailing Address - Street 1:222 N MISSION ST STE C
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6643
Mailing Address - Country:US
Mailing Address - Phone:509-663-1161
Mailing Address - Fax:
Practice Address - Street 1:222 N MISSION ST STE C
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6643
Practice Address - Country:US
Practice Address - Phone:509-663-1161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty