# DR. JUSTIN MOODY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Dental Implant Center - Tacoma
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194577171
- **Authorized official:** CRAIG SMITH DDS (MANAGING DENTIST)
- **Authorized official phone:** (253) 752-6349

## Contact information

- **Practice address:** 2501 N PEARL ST, TACOMA, WA 98406-2540
- **Practice address phone:** (253) 752-6349
- **Mailing address:** 2501 N PEARL ST, TACOMA, WA 98406-2540
- **Mailing address phone:** (253) 752-6349

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/03/2024
- **Last updated:** 07/30/2024