# MICHAEL S MOODY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760739825
- **Gender:** Man
- **Credential:** D.M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 9433 | AZ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | S2-155C | NV | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | DRP1048 | FL | — |

## Other

- **Enumeration date:** 08/08/2012
- **Last updated:** 04/09/2019