Individual
MISS REOLA JIMPERSON MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
16 W 137TH ST, WP BLDG. 2ND FL., NEW YORK, NY 10037-1901
(212) 939-1000
(212) 939-2885
Mailing address
123 E 129TH ST, APT. 6N, NEW YORK, NY 10035-1117
(212) 939-1000
(212) 939-2885
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
017591
NY
Other
Enumeration date
03/23/2011
Last updated
03/23/2011
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