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Organization
MIKE MOODY LLC
Active
Organization
MIKE MOODY LLC
Active
Other names
Uptown Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THOMAS MOODY DDS (DENTIST)
(503) 223-5040
Entity
Organization
Contact information
Practice address
2330 NW FLANDERS ST STE 204, PORTLAND, OR 97210-3460
(503) 223-5040
Mailing address
2330 NW FLANDERS ST STE 204, PORTLAND, OR 97210-3460
(503) 223-5040
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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