Individual
MS. TRACYE A. MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, BS, MS
Contact information
Practice address
NAVAL HEALTH CLINIC JOINT RESERVE BASE, DENTAL DEPARTMENT BLDG 137, WILLOW GROVE, PA 19090
(215) 443-6380
(215) 443-6378
Mailing address
324 E PHIL ELLENA ST, PHILADELPHIA, PA 19119-1941
(215) 438-6199
(215) 443-6378
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH008983L
PA
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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