# BRIAN P. MOODY, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023329620
- **Authorized official:** DR. BRIAN P MOODY DDS (DENTIST)
- **Authorized official phone:** (206) 285-1338

## Contact information

- **Practice address:** 4055 21ST AVE W, SUITE 101, SEATTLE, WA 98199-1247
- **Practice address phone:** (206) 285-1338
- **Practice address fax:** (206) 285-4665
- **Mailing address:** 4055 21ST AVE W, SUITE 101, SEATTLE, WA 98199-1247
- **Mailing address phone:** (206) 285-1338
- **Mailing address fax:** (206) 285-4665

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00010023 | WA | Yes |

## Other

- **Enumeration date:** 06/29/2010
- **Last updated:** 06/29/2010