# MOODY FAMILY DENTAL, LLC

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

## Provider details

- **NPI number:** 1487710190
- **Authorized official:** DR. IRIS L LEWIS MOODY D.D.S. (DENTIST)
- **Authorized official phone:** (215) 848-6446

## Contact information

- **Practice address:** 10 E SCHOOL HOUSE LANE, PHILADELPHIA, PA 19144
- **Practice address phone:** (215) 848-6446
- **Practice address fax:** (215) 848-7202
- **Mailing address:** 10 E SCHOOL HOUSE LANE, PHILADELPHIA, PA 19144
- **Mailing address phone:** (215) 848-6446
- **Mailing address fax:** (215) 848-7202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS024507L | PA | Yes |
| 122300000X | Dentist | DS23581L | PA | — |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 01/14/2014