Individual
LYNNE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
121 COUNTY ST, LAKEVILLE, MA 02347-1811
(774) 849-0551
Mailing address
121 COUNTY ST, LAKEVILLE, MA 02347-1811
(774) 849-0551
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH10503
MA
125K00000X
Advanced Practice Dental Therapist
DH10503
MA
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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