Individual
FLORENCE E MOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST
Contact information
Practice address
1802 E COLUMBUS DR, EAST CHICAGO, IN 46312-2826
(219) 397-6916
(219) 397-9313
Mailing address
100 W CHICAGO AVE STE F, EAST CHICAGO, IN 46312-3261
(219) 703-2583
(219) 703-6749
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13002162A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13002162A
INDIANA LICENSE
IN
Enumeration date
02/20/2020
Last updated
02/20/2020
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