Individual
MRS. ANDREA HICKSON-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
361 MAPLE ST, 9B, BROOKLYN, NY 11225-5134
(347) 787-2259
Mailing address
361 MAPLE ST, 9B, BROOKLYN, NY 11225-5134
(347) 787-2259
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
001958
NY
124Q00000X
Dental Hygienist
Primary
024517
NY
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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