# BRIAN MOODY, DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creekside Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689128746
- **Authorized official:** DR. BRIAN MOODY DDS (OWNER)
- **Authorized official phone:** (425) 485-0300

## Contact information

- **Practice address:** 19214 BOTHELL WAY NE, SUITE C, BOTHELL, WA 98011-6066
- **Practice address phone:** (425) 485-0300
- **Mailing address:** 19214 BOTHELL WAY NE, SUITE C, BOTHELL, WA 98011-6066
- **Mailing address phone:** (425) 485-0300

## Taxonomy

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

## Other

- **Enumeration date:** 08/06/2016
- **Last updated:** 08/06/2016