Provider Demographics
NPI:1952302499
Name:MOORE-MEAUX, MONA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:MARIE
Last Name:MOORE-MEAUX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 SALEM SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-1495
Mailing Address - Country:US
Mailing Address - Phone:757-427-1669
Mailing Address - Fax:
Practice Address - Street 1:4433 SALEM SPRINGS WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1495
Practice Address - Country:US
Practice Address - Phone:757-427-1669
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery