Individual
MARLENE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
675 MAIN STREET, MIDDLETOWN, CT 06457
(860) 347-6971
Mailing address
4 TWIN OAK CT, AVON, CT 06001-4538
(860) 305-4966
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6192
CT
Other
Enumeration date
04/12/2017
Last updated
04/12/2017
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